动态血压相关指标对冠心病患者心血管事件的预测价值

Predictive value of ambulatory blood pressure related parameters on cardiovascular events in patients with coronary heart disease

目的研究动态血压相关指标对冠心病患者新心血管事件的预测价值。方法选择2011年5月~2013年5月,余姚市人民医院确诊冠心病患者255例,均行动态血压检测,定期进行随访,记录患者心脑血管事件发生情况,采用Cox比例风险回归分析探讨影响心血管事件的因素。结果观察组患者年龄、糖尿病、高血压、吸烟比例均高于对照组,差异有统计学意义（P〈0.05）。观察组患者24h平均收缩压（142.2±15.5）mm Hg、24h平均动态舒张压（95.6±8.6）mm Hg、24h平均脉压（78.2±11.5）mm Hg、动态脉压指数（0.68±0.06）均高于对照组患者,差异有统计学意义（t=4.17、4.68、3.38、7.38,均P〈0.05）。动态脉压指数（PPI）上升0.1（P=0.014）、24h平均收缩压（MSBP）上升10mm Hg（P=0.04）、24h平均脉压（MPP）上升10mm Hg（P=0.012）是患者心血管事件的独立风险因素。结论动态血压相关指标有助于预测冠心病患者心血管事件,值得临床运用。

Objective To assess the predictive value of ambulatory blood pressure related parameters on cardiovascular events in patients with coronary heart disease. Methods 255 patients with coronary heart disease diagnosed in our hospital were recruited in the study from May 2011 to May 2013.All patients underwent ambulatory blood pressure monitoring and were followed up regularly to record the incidence of cardiovascular and cerebrovascular events.Factors influencing the events were analyzed using Cox proportional hazard regression model. Results The percentages of patients who had diabetes,high blood pressure and who smoked were higher in the event group than those in the control group,the difference was statistically significant（P〈0.05）,and they were much older.The 24 h MSBP,24 h MDBP,24 h MPP,and PPI in the event group were142.2±15.5,95.6±8.6,78.2±11.5and 0.68±0.06,which were significantly higher than those in the control group（P〈0.05）.The independent risk factors of cardiovascular events were found to be 0.1 increase of PPI（P=0.014）,10 mmHg increase of 24h MSBP（P=0.04） and 10 mmHg increase of 24h MPP（P=0.012）.Conclusions Dynamic blood pressure related indicators can help predict cardiovascular events in patients with coronary heart disease,which is worthy of clinical application.