不同方法的动脉压值在不同程度冠状动脉硬化患者中的意义研究

Research of significance by different arterial pressure values in patients with different degree of coronary arteriosclerosis

目的比较不同程度的冠状动脉(冠脉)硬化患者不同方法的动脉压值相关性及其在冠脉动脉硬化中的意义。方法 113例冠脉造影患者,74例为非冠心病患者(非冠心病组),39例为冠心病患者(冠心病组)。均采取Judkins法,经右侧桡动脉路径行左右冠选择性冠脉造影。在造影过程中分别记录比较无创肱动脉压、有创桡动脉压及有创中心动脉压的收缩压和舒张压,并分析冠脉病变与动脉压的关系。结果非冠心病组及冠心病组患者有创中心动脉压、无创肱动脉压、有创桡动脉压的收缩压、舒张压比较差异均无统计学意义(P>0.05),脉压、平均动脉压在不同方法下比较差异无统计学意义(P>0.05)。非冠心病组与冠心病组相应动脉压及脉压、平均动脉压比较差异均无统计学意义(P>0.05)。不同支数冠脉病变患者各种脉压比较差异均无统计学意义(P>0.05)。结论临床无创肱动脉压与有创动脉压有较好的相关性及一致性,动脉压值的测量从一定程度上并不能反映患者的冠脉病变情况。

Objective To compare correlation and significance by different arterial pressure values in patients with different degree of coronary arteriosclerosis. Methods Among 113 patients receiving coronary angiogram, there were 74 cases without coronary heart disease（non-coronary heart disease group） and 39 cases with coronary heart disease（coronary heart disease group）. They all received Judkins method and left and right selective coronary angiogram through right radial artery. Records during angiogram were made on systolic pressure and diastolic pressure of non-invasive brachial arterial pressure, invasive radial arterial pressure, invasive central arterial pressure to analyze relationship between coronary artery lesions and arterial pressure. Results There was no statistically significant difference of systolic pressure and diastolic pressure of invasive central arterial pressure, non-invasive brachial arterial pressure, and invasive radial arterial pressure in non-coronary heart disease group and coronary heart disease group（P〉0.05）, and their difference of pulse pressure and mean arterial pressure had no statistical significance between various measures（P〉0.05）. There was no statistically significant difference of corresponding arterial pressure, pulse pressure and mean arterial pressure between non-coronary heart disease group and coronary heart disease group（P〉0.05）. Pulse pressure between patients with different coronary artery lesions had no statistically significant difference（P〉0.05）. Conclusion Clinical non-invasive brachial arterial pressure and invasive arterial pressure contain good correlation and consistency, while arterial pressure measurement reveals limited reflection of coronary artery lesions.