高血压与冠状动脉狭窄程度的相关性研究

Correlation between hypertension and degree of coronary artery stenosis

目的探讨高血压与冠状动脉病变狭窄程度的关系。方法选择9762例疑诊冠心病患者,其中合并高血压病的5912例患者作为观察组,未合并高血压病的3850例患者作为对照组。采用Gensini积分评价冠状动脉造影病变程度,并计数冠状动脉病变的支数。采用单因素方差分析及多因素回归分析观察高血压病与冠状动脉狭窄程度间的关系。结果观察组冠状动脉单支病变及多支病变的发生率均显著高于对照组(P<0.05),对照组冠状动脉正常的比例明显高于观察组(P<0.001)。积分1组与积分2组中,未合并高血压患者的比例明显高于合并高血压者(P<0.05),而积分3组与积分4组中合并高血压者的比例明显高于未合并高血压者(P<0.001)。多因素回归分析结果显示在高血压患者中,性别和糖尿病史对冠心病有独立的预测价值。结论高血压是冠心病的重要危险因素,高血压合并冠心病患者的糖尿病发病率较高。在降压的同时减少其他危险因素的发生,可能对改善高血压患者冠心病的预后具有重要意义。

Objective To investigate the correlation between hypertension and coronary stenosis.Methods Nine thousand seven hundred and sixty-two patients with suspected coronary heart disease（CHD） were divided into two groups： with hypertension（n=5912） and without hypertension（n=3850） groups.CHD severity was assessed by the Gensini score and number of arteries（03） with 〉50% stenosis shown by the angiography.The correlation between hypertension and coronary stenosis was observed by both single factor analysis and multivariate binary logistic regression analysis.Results The incidences of both single and multi-vessel lesions were higher in patients with hypertension than in those without hypertension（P〈0.001）,while the ratios of normal coronary artery were higher in patients without hypertension than in those with hypertension.In group 1 and group 2 of Gensini score,the ratios of patients without hypertension were significantly higher than those with hypertension,while in group 3 and group 4 of Gensini score,the ratios of patients with hypertension were significantly higher than those without hypertension.With multivariate analysis,it was found that gender and diabetes history were the best predictors of CHD for the patients with hypertension.Conclusions Hypertension is an important risk factor for CHD.CHD patient with hypertension may have a higher incidence of diabetic disease.For patients with hypertension,more attention should be paid on lowering other risk factors besides lowering the blood pressure,thus the outcome of CHD patients could be improved.