老年高血压患者平均脉压与冠状动脉病变严重程度的相关性研究

The Correlation Between Mean Pulse Pressure And Coronary Artery Lesions In elderly Patients with Hypertension

目的:探讨平均脉压与老年高血压患者冠状动脉病变严重程度的相关性。方法 :选择390例老年原发性高血压患者(≥60岁),按PP水平分为A组(PP<50mmHg)和B组(PP≥50mmHg)。记录所有患者性别、年龄、吸烟史、2型糖尿病病史、身高、体重、体重指数(BMI)、血清总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)。行动态血压监测,并计算平均脉压(PP),以Judkins法行冠状动脉造影术,根据冠脉狭窄程度及病变血管解剖分布计算Gensini评分。比较两组Gensini评分,对可能影响冠状动脉病变的因素进行单因素相关分析,并以Gensini评分为因变量,和各相关因素进行多元逐步回归分析。结果 :B组Gensini评分显著高于A组(P<0.01)。通过单因素相关分析,影响Gensini评分的因素包括与冠脉病变严重程度相关的因素:年龄、2型糖尿病史、吸烟史、SBP、PP、TC、LDL-C,其中以PP影响最明显(r=0.56,P<0.01)。在校正了年龄、2型糖尿病史、吸烟史、SBP、TC、LDL-C等因素影响后,这种相关性仍然存在(R2=0.52,P<0.01)。结论 :PP与老年高血压患者冠脉病变严重程度有较好的相关性。

Objective To explore the correlation of mean pulse pressure and coronary artery lesions in elderly patients with hypertension.Methods Three hundred ninety elderly patients with hypertension were divided into two groups（group A： PP50mmHg,group B： PP≥50mmHg）.Patients＇ sex,age,smoking history,2-diabetes mellitus,ambulatory blood pressure,height,weight,TG,TC,HDL-C and LDL-C were recorded;BMI and PP were calculated.The severity of coronary artery lesions were evaluated by Gensini score according to the result of coronary artery angiography.Gensini score of the two groups were compared with each other.Correlations between the factors and coronary lesions were assessed by simple correlation coefficients and multivariable linear regression.Results Gensini score in group B is higher than that in group A（P0.01）.Assessed by simple correlation coefficients,PP,age,2-diabetes mellitus,smoking,SBP,TC and LDL-C were found correlated to Gensini score.PP was the most significant factor（r=0.562,P0.001）.In the multivariable linear regression,PP（R2=0.515） was associated with Gensini score after adjustment for age,2-diabetes mellitus,smoking,SBP,TC and LDL-C.Conclusions PP was well correlated with severity of coronary artery lesions in elderly patients with hypertension.