女性早发急性冠脉综合征血压变异性的研究

Blood pressure variability in female patients with premature acute coronary syndrome

目的:对女性早发急性冠脉综合征(ACS)24 h动态血压变异特点及心血管危险因素进行研究。方法:100例经冠脉造影确诊为ACS的女性患者,按年龄分为早发组(年龄≤65岁)50例和晚发组(年龄>65岁)50例,对两组各时段血压平均水平、各时段血压标准差、各时段血压变异系数、临床生化指标等比较,探讨女性早发ACS的独立危险因素。结果:(1)两组在空腹血糖、部分时段血压平均水平、部分时段血压标准差、部分时段血压变异系数等早发组高于晚发组,有显著差异(P<0.05)。(2)Logistic回归分析示:空腹血糖、白昼平均动脉压标准差、夜间平均动脉压标准差是女性早发ACS的独立预测因素。结论:针对女性早发ACS的独立预测因素,积极控制血糖和血压波动性可能延缓动脉粥样硬化过程,预防女性早发ACS。

Objective： To investigate the characteristics of 24 h blood pressure variability （BPV） and the cardiovascular risk factors in female patients with premature acute coronary syndrome（ACS） ambulatory blood pressure monitoring（ABPM）. Methods：A hundred female patients with ACS were divided into two groups by age： premature ACS （ n=50, ~〈65 years） and mature ACS （n=50, 〉65years）. The characteristics of BPV and other clinical risk factors of coronary heart disease （CHD） were compared and analyzed statistically, and the predictors for female premature ACS were screened by multi-factor analysis. Results： （1） In the average level of blood pressure and blood pressure standard deviation and variable coefficient in some periods, as well as fasting blood glucose, premature ACS group were significantly higher than the mature ACS group （P〈0.05）. （2） Multiple logistic regression analysis showed that fasting blood glucose, daytime mean arterial pressure standard deviation, nighttime mean arterial pressure standard deviation were independent predictors for the female premature ACS. Conclusion：Fasting blood glucose, daytime mean arterial pressure standard deviation, nighttime mean arterial pressure standard deviation are independent predictors for the female premature ACS. By controlling the high BPV and fasting blood glucose , premature ACS may be reduced in female.