老年高血压患者动态脉压指数与冠状动脉病变的相关性研究

A correlation research between dynamic pressure indexes and coronary artery disease in elderly hypertensive patients

目的探讨老年高血压患者动态脉压指数(PPI)与冠状动脉病变之间的相关性。方法 2009～2011年该院收治的接受冠状动脉造影的老年患者332例,所有研究对象均进行24h的动态血压监测。记录脉压(PP)、收缩压(SBP)、舒张压(DBP)及心率(HR)。采用常规Judkins法行选择性左、右冠状动脉造影,定量系统分析冠状动脉病变程度。分析PPI、PP、SBP、DBP、平均血压(MBP)与冠状动脉病变的相关性。结果所有患者经过冠状动脉造影诊断,发现有冠心病者220例(66.3%),而非冠心病者112例(33.7%)。0.40<PPI≤0.50区间患者最多,PPI≥0.6区间的患者最少。PPI值越高,患者年龄越高,SBP、PP及冠状动脉病变越多,结果差异有统计学意义(P<0.05)。冠状动脉病变发生的危险因素与PPI、PP、SBP相关。结论 PPI较PP能更准确地预测心血管疾病,尤以24h动态PPI的预测价值更大。

Objective To explore the correlation between the dynamic pressure index in elderly hypertensive patients with coro- nary artery disease. Methods 332 gerontal patients with hypertension who received coronary angiography in our hospital from January 2009 to December 2011 were selected and conducted ambulatory blood pressure monitoring for 24h. The PP, SBP, DBP and heart rate were recorded. The conventional Judkins method was used to perform the selective left and right coronary angiography, and the severity of coronary artery lesions was analyzed with quantitative analysis system. Then the correlation among PPI, PP, SBP,DBP,MBP and coronary artery lesions was investigated. Results 220 cases were diagnosed with coronary heart disease,accounting for 66.3%. Most patients were in 0.40--0.50 in PPI, fewer patients were in 0.50-0.60 and the patients in PPI more than 0.6 were the least. There were more SBP,PP and coronary artery lesions when the PPI value and patient age were higher,and the result was statistically significant. The risky factors of coronary artery lesions include PPI, PP and SBP. Conclusion PPI can predict cardiovascular disease more accurately compared with PP,and the 24 h dynamic PPI has the largest prediction value.