冠心病合并高血压患者冠状动脉病变临床特点分析

Clinical Characteristics of Coronary Artery Disease in Patients with Coronary Heart Disease Complicated with Hypertension

目的:探讨冠心病合并高血压患者冠状动脉病变临床特点。方法:本研究病例来源于2010年4月-2015年11月期间我院心内科收治的冠心病患者340例,按照是否合并高血压分为高血压组(n=148)与非高血压(n=192),行冠状动脉造影检查,比较两组患者临床表现、危险因素及冠状动脉病变造影结果。结果:两组典型胸痛和心源性休克发生率比较无统计学差异(P>0.05);高血压组心律失常、心肌梗死、心力衰竭发生率明显高于非高血压组(P<0.05);两组性别、肥胖病史、吸烟史、血糖水平、TC、TG、HDL-C、LDL-C水平比较无统计学差异(P>0.05);高血压组年龄明显高于非高血压组(P<0.05);高血压组单支血管病变明显少于非高血压(P<0.05)、三支及弥漫病变明显多于非高血压(P<0.05),而两组两支血管病变比较无统计学差异(P>0.05)。结论:冠心病合并高血压患者心律失常、心肌梗死、心力衰竭发生率高,冠状动脉弥漫病变严重,累及左主干较多。

Objective： To investigate the clinical characteristics of coronary artery lesions in patients with coronary heart disease complicated with hypertension. Methods：340 patients with coronary heart disease in our hospital from April 2010 to November 2015, according to whether or not combined with hypertension were divided into hypertension group （n=148） and non hypertension （n=192）. Coronary artery angiography was performed. The clinical manifestations, risk factors and angiographic findings of coronary artery lesions were compared between two groups. Results. there was no significant difference between the two groups of typical chest pain and the incidence of shock （P〉0.05）; The incidence of arrhythmia, myocardial infarction and heart failure in hypertension group were significantly higher than those in non hypertension group （P〈0.05）; There was no significant difference in gender, obesity, smoking history, smoking history, blood glucose level, TG, HDL-C, TC, and LDL-C levels in the two groups （P〉O.05） ; The age of hypertension group was significantly higher than that of non hypertension group （P〈 0.05）; The single vessel disease in hypertension group was significantly less than that of non hypertension （P〈0.05）, three and diffuse lesions was significantly more than non hypertension （P〈0.05）. But there was no significant difference in the two vessel diseases between the two groups （P〉O.05）. Conclusion： coronary heart disease combined with hypertension, myocardial infarction, heart failure, aging, serum hs-CRP and IL-6 levels increased as its risk factors, coronary artery diffuse lesions, the left main trunk stenosis.