冠心病并发高血压病患者的预后较差

Poor prognosis in patients with coronary heart disease and hypertension

目的观察冠心病并发高血压病患者的近期预后。方法对我院心血管内科2010年4月-2012年8月收治的220例冠心病患者,按是否并发高血压病,分为：冠心病并发高血压病组（高血压病组,120例）和未并发高血压病组（非高血压病,100例）,对2组患者随访观察24个月，统计分析两组主要不良心脑血管事件（MACCE）的发生率。结果高血压病组的SBP、DBP、脉压（PP）显著高于非高血压病组（P〈0.01）；高血压病组的冠脉病变评分显著高于非高血压病组（P〈0.01）。高血压病组的再次心肌梗死、心力衰竭、严重心律失常、卒中、病死率均显著高于非高血压病组（均P〈0.05）。但是,两组MACCE总发生率（30%vs. 20%）的差异未达到显著水平。高血压病组的无心血管不良事件中位生存期为15.0个月、非高血压病组为22.0个月，两组中位生存期比较差异显著（P〈0.05）。结论冠心病并发高血压病患者近期预后较差,且发生MACCE的时间提前。

AIM To observe the short-term prognosis in patients with coronary heart disease （CHD） complicated with hypertension. METHODS Two hundred and two patients with CHD in the Cardiovascular Department of our hospital from April 2010 to August 2012 were divided into the following： coronary heart disease complicated with hypertension group （ hypertension group, n = 120 ） and coronary heart disease with no complication group （ no hypertension group, n = 100）. The two groups were followed up for 24 months and major adverse cardiac and cerebrovascular events （MACCE） incidence rates were compared between groups. RESULTS Systolic blood pressure （SBP）, diastolic blood pressure （DBP） and pulse pressure （PP） in the hypertension group were significantly higher than those in the group without hypertension （P 〈0. 01 ）. The coronary lesion score in the hypertension group was significantly higher than in the group without hypertension （P 〈 0. 01 ）. The rates of heart failure, relapse of myocardial infarction, serious arrhythmia, stroke, and death in hypertension group were significantly higher than in the group without hypertension （ P 〈 0. 05 ）. However, no significant difference was observed in the total rate of MACCE （30% vs. 20% ） between groups. The median survival times of no MACCE in the hypertension group and the group without hypertension were, respectively, 15 months and 22 months, with significant difference between groups （P 〈 0. 05 ）. CONCLUSION The prognosis is poor in patients with coronary heart disease complicated with hypertension. There is a tendency of early occurrence of MACCE.