正常高值血压者血压晨峰与冠状动脉病变严重程度的相关性

Relationship Between Morning Blood Pressure Surge and Severity of Coronary Artery Lesions in lndividuals With Normal High Blood Pressure

目的 :探讨正常高值血压者血压晨峰与冠状动脉病变严重程度的相关性。方法:选择正常高值血压可疑冠状动脉性心脏病(冠心病)住院患者156例,均完善24 h动态血压及冠状动脉造影检查。根据动态血压结果,将患者分为晨峰组(65例)和非晨峰组(91例),比较两组的冠状动脉病变程度。冠状动脉病变程度用病变支数、分型及Gensini总积分表示。结果:晨峰组24 h平均收缩压、白天平均收缩压及夜间平均收缩压均高于非晨峰组(P<0.05);晨峰组的收缩压晨峰高于非晨峰组(P<0.05);晨峰组冠状动脉病变率、三支病变率及C型病变率高于非晨峰组(P<0.01),而单支病变率和A型病变率低于非晨峰组(P<0.01);晨峰组Gensini总积分显著高于非晨峰组(P<0.01);晨峰组非杓型血压节律发生率高于非晨峰组(P<0.05);多元线性回归分析显示,年龄、24 h平均收缩压及晨峰程度为冠状动脉病变独立影响因素。结论:正常高值血压者血压晨峰与冠状动脉病变程度密切相关。

Objective： To investigate the relationship between moming blood pressure surge （MBPS） and severity of coronary artery lesions in patients with normal high blood pressure. Methods： A total of 156 patients of suspicious coronary artery disease （CAD） who received coronary angiography and 24-hour ambulatory blood pressure monitoring （ABPM） were studied. The patients were divided into 2 groups, MBPS group, n= 65 and Non-MBPS group, n=91. The severity of coronary lesions and the classification were measured by the number of vessel involved and Gensini scores, the results were compared between 2 groups. Results： Compared with Non-MBPS group, MBPS group showed increased 24-hour average SBP, day average SBP, night average SBP, P〈0.05 and higher morning surge of SBP, P〈0.05. MBPS group presented the higher rate of coronary lesion, 3-vessel disease, type C lesion, P〈0.01; higher total Gensini scores, P〈0.01 and higher non-dipper blood pressure pattern, P〈0.05. Multi regression analysis indicated that age, 24-hour average SPB and MBPS were the independent risk factors for coronary lesions. Conclusion： The MBPS is closely related to the severity of coronary lesions in patients with normal high blood pressure.