24小时动态脉压与冠状动脉病变严重程度的相关性研究

Study of Relationship Between 24-h Pulse Pressure and Severity of Coronary Heart Disease

目的：探讨24小时动态脉压(PP)水平与冠状动脉(冠脉)病变严重程度的关系。方法：对156例入选病例均行冠脉造影术。冠脉病变的严重程度用冠脉病变的血管支数及 Gensini 积分表示。所有病例均在术前、术后测量肱动脉血压,术后进行24小时动态血压监测。结果：高血压患者较非高血压患者冠心病患病率明显增高(73.6%比58.4%P=0.038)。高血压患者冠脉三支血管病变的患病率显著高于非高血压患者(35.2%比12.3%,P=0.001)。冠脉狭窄患者,无论肱动脉测压、还是24小时动念测压,其收缩压(SBP)、脉压均显著高于冠脉正常组,有显著差异(P＜0.05),且收缩压与脉压随着血管狭窄支数的增加而逐渐增加。结论：脉压是冠心病冠脉狭窄发生发展的相关因素,且24小时动态 PP 的预测价值更大。

Objective： To evaluate the relationship of the pulse pressure （PP） to the severity of coronary artery disease. Methods： One hundred and fifty-six patients underwent coronary angiography. The severity of coronary artery lesions was evaluated by the number of diseased arteries and Gensine score. Brachial systolic blood pressure （SBP） and diastolic blood pressure （DBP） were measured before and after coronary angiography. All subjects underwent 24-h arterial blood pressure monitoring （ABPM） . Results： Brachial SBP and PP, Aortic SBP and PP, 24-h arterial blood pressure monitoring（ABPM） SBP and PP were all significantly higher in patients with coronary artery disease than in the normal subjects. Multiple regression analysis indicated that ABPM PP, Brachial PP, and age were the best predictors for the severity of coronary lesions. Conclusion ： PP is an independent risk factor for coronary artery disease and the severity of coronary artery stenosis, and AB-PM PP is a more valuable predictor.