脉压与冠状动脉病变程度的相关性分析

Analysis of Correlation Between Pulse Pressure and Severity of Coronary Artery Lesion

目的探讨脉压水平与冠心病冠状动脉病变严重程度的关系。方法对759例冠状动脉造影的病案资料进行回顾登记,多因素有序logistic回归分析评价脉压,以及其他心血管病危险因素与冠状动脉病变严重程度之间的关系;以60mmHg为界将所有病例分为高脉压与低脉压2组,分析比较2组患者间一般情况及冠状动脉病变严重程度的差异;以是否合并高血压对患者分为2个亚组,分析亚组内不同冠状动脉病变程度患者间脉压的差异。结果多因素有序logistic回归分析显示脉压与冠状动脉病变严重程度无相关。高脉压与低脉压2组患者一般情况的多个项目存在差异,高脉压组3支病变患者的比例高于低脉压组(17.4%vs9.9%,P=0.003)。高血压亚组冠状动脉3支病变患者的比例高于正常血压亚组(16.3%vs8.9%,P=0.004);高血压亚组内不同程度冠状动脉病变患者之间的脉压水平具有显著性差异(F=5.08,P=0.001),3支病变和2支病变患者的脉压高于1支病变者,正常血压组内不同病变程度患者之间无差异(F=0.70,P=0.56)。结论总体分析脉压与冠状动脉病变严重程度无相关。在高血压亚组内,不同冠脉病变程度患者之间的脉压存在差异,3支病变和2支病变患者的脉压显著高于1支病变。

[Objective] To study the correlation between pulse pressure and severity of coronary artery lesion . [Methods] A total of 759 patients undergone coronary angioplasty were enrolled in this study. All of the cases were divided into 2 groups according to their pulse pressure at the level of 60 mmHg. The general conditions and the severity of coronary artery lesion were compared between the high PP group and the low PP group. Stepwise multinominal ordinal logistic regression was used to screen out the predictors for the severity of coronary artery lesion from PP and other risk factors of cardiovascular diseases. Furthermore, the correlation between the PP and severity of coronary artery lesion was analyzed in hypertensive and normotensive subgroups of all cases. [ Results ] There were some difference between the general condition of high PP group and low PP group, and the high PP group had a higher proportion of 3-vessle lesion cases of coronary artery than the low PP group （17.4% vs 9.9%, P=0.003）. Stepwise multinominal ordinal logistic regression showed that PP was not an independent predictor for severity of coronary artery lesion. Hypertensive subgroup had a higher proportion of 3-vessle lesion cases of coronary artery than normotensive group （16.3% vs 8.9%, P=0.004）. In covariance analysis, PP was different signiilcanfly in different cases of coronary artery lesion in hypertensive subset （F=5.08, P=0.001）, and was not significantly different in normotensive subset （F=0.70, P=0.56）. In hypertensive subset, PP of patients with 2-vessel lesion and 3-vessel lesion was higher than that of patients with 1-vessel lesion.[Conclusion] In overall analysis. PP is not a significant predictor for the severity of coronary artery lesion. In the hypertensive subset, there was significant difference among the patients with different severity of coronary artery lesion. PP of patients with 2 or 3 vessels lesion were higher than that of patients with 1 vessel lesion.