3^(rd)M-SBPRR对高血压患者冠状动脉病变程度判断的价值

The Diagnostic Value of 3^(rd)M-SBPRR to Evaluate the Coronary Artery Stenosis in Essential Hypertension Patients

目的评价原发性高血压(EH)患者运动负荷试验结束后第3min收缩压恢复率(3rdM-SBPRR)和冠状动脉病变程度的关系及其对左主干狭窄的预测价值。方法对560个在3个月内完成了冠状动脉造影和运动负荷试验的EH患者按3rdM-SBPRR水平分为4个百分位数组,对各组间不同冠状动脉病变支数的百分率进行χ2检验。以受试者工作曲线(ROC)来分析3rdM-SBPRR预测左主干狭窄的临床意义。结果按照3rdM-SBPRR水平将患者分为4个百分位数组,P76~P100(1.13~1.42)组三支冠状动脉病变比率显著高于P1~P25(0.73~0.86)组、P26~P50(0.87~0.99)组和P51~P75(1.00~1.12)组,而单支冠状动脉病变比率显著低于上述3组;Gensini积分随着3rdM-SBPRR水平的升高而增高,且P76~P100(1.13~1.42)组显著高于其他3组。受试者工作曲线分析示3rdM-SBPRR用于判断左主干狭窄有显著意义(P=0.000),3rdM-SBPRR水平越高则左主干狭窄的可能性越大;3rdM-SBPRR水平为1.12时,其预测左主干狭窄的灵敏度为84.1%,特异度为78.1%。结论在EH患者其3rdM-SBPRR水平越高,则冠状动脉病变程度越重,3rdM-SBPRR可作为预测EH患者左主干狭窄的一个有效指标。

Objective To evaluate the post exercise systolic blood pressure and the degree of coronary artery stenosis and find the left main coronary artery stenosis in essential hypertension patients. Methods 560 essential hypertension patients who were received treadmill test and coronary angiography within 90 days were divided into four quartile groups based on the third minute systolic blood pressure recovery ratio level. We compared the ratio of single coronary artery stenosis or double coronary artery stenosis or three coronary artery stenosis in the four groups with Chi - Square test. ROC curve of 3^rdM - SBPRR level was used to analysis the predictive value for left main coronary artery stenosis. Results The ratio of three vessels coronary artery stenosis in the P76- P100 （ 1.13 - 1.42） group was the highest among the four groups, and the ratio of single vessels coronary artery stenosis in the P76 - P100 （ 1.13 - 1.42） group was the lowest. ROC curve of 3^rdM - SBPRR level analysis showed 3^rdM - SB- PRR was valuable for predicting left main coronary artery stenosis （ P = 0. 000）, increased quartiles of 3 ^rd M - SBPRR levels were associated with increased left main coronary artery stenosis ratio. The predictive sensitivity of main coronary artery stenosis was 84.1% and the specificity was 78. 1% when 3^rd M - SBPRR level was 1.12. Conclusion The increased 3^rdM - SBPRR was associated with deteriorated coronary artery stenosis in essential hypertension patients. The 3^rdM -SBPRR level can be a predictive factor for left main coronary artery stenosis.