脉压与冠状动脉狭窄严重程度的相关性研究

The relationship between pulse pressure and severity of coronary artery disease

目的探讨脉压与冠状动脉病变狭窄严重程度的相关性。方法对拟诊冠心病或确诊冠心病的住院患者405例,行冠状动脉造影术。根据病变累及左前降支、左回旋支和右冠状动脉支数分为4组:冠状动脉正常组(102例)、单支病变组(77例)、双支病变组(102例)和3支病变病(124例)。冠状动脉病变狭窄的严重程度用病变的血管支数及Gensini积分表示。所有患者在术中测量主动脉血压及外周桡动脉血压。结果3支病变组主动脉、外周桡动脉收缩压和脉压均显著高于冠状动脉正常组(P<0.05),双支病变组主动脉收缩压、外周桡动脉收缩压和脉压显著高于冠状动脉正常组,单支病变组与冠状动脉正常组差异无统计学意义。收缩压与脉压随着狭窄支数的增加而增加。多因素分析结果显示,主动脉脉压、桡动脉脉压、年龄与冠状动脉狭窄程度的关系最为密切。结论脉压是冠心病冠状动脉狭窄发生发展的独立危险因素,且主动脉脉压的预测价值更大。

Objective To evaluate the relationship between pulse pressure （PP） and the severity of coronary artery stenosis. Methods 405 patients were enrolled. Of them, 271 were men and 134 women,whose ages were 33-85（ 63.02±11.18 ）years. All patients underwent coronary angiog- raphy. The severity of coronary artery stenosis was evaluated by the number of diseased arteries and Gensini score. Aortic blood pressure and radial artery blood pressure were measured during coronary angiography. Results The aortic SBP and PP,and radial SBP and PP were significantly higher in patients with coronary artery disease than in the normal subjects. Multiple regression analysis indicated that aortic PP, radial PP,and age were closely related to the severity of coronary lesions. Conclusion PP is an independent risk factor for the severity of coronary artery stenosis, and aotic PP is a better predictor.