24小时动态血压监测与冠状动脉病变的关联性分析

Association between 24-hour ambulatory blood pressure monitoring and coronary artery disease

目的探讨临床施以24小时动态血压监测同冠状动脉病变表现出的相关性。方法选择我院2015年12月~2017年1月收治的62例冠心病患者作为实验对象;依据患者是否患有高血压疾病展开分组,分别设为高血压组以及非高血压组;依据患者表现出的病变程度,针对患者施以分组,分别为A1组(冠状动脉正常组)、A2组(单支病变组)、A3组(双支病变组)以及A4组(三支病变组);针对所有冠心病患者于临床施以冠状动脉造影操作。之后利用冠状动脉病变Gensini积分以及血管支数针对冠状动脉病变表现出的严重程度加以表示。对于所有患者在施以手术前以及手术后,针对患者的肱动脉血压水平施以准确测量,完成手术后针对所有患者的24小时动态血压水平施以监测工作。结果在出现冠状动脉三支血管病变概率方面,同非高血压组患者比较,高血压组患者呈现出较为明显的增加(P<0.05);在血压水平以及脉压水平几方面,同非高血压组患者比较,高血压组患者呈现出较为明显的增加(P<0.05);在血压水平以及脉压水平几方面,同冠状动脉正常患者比较,冠状动脉狭窄患者呈现出较为明显的增加(P<0.05)。结论对于冠心病患者而言,针对冠状动脉狭窄的出现以及病症发展加以分析发现,脉压为主要原因,对患者施以24小时动态血压水平监测,呈现出显著价值。

Objective To investigate the association between 24-hour ambulatory blood pressure monitoring and coronary artery disease. Methods A total of 62 patients with coronary artery disease who were admitted to our hospital from December 2015 to January 2017 were enrolled, and according to the presence or absence of hypertension, these patients were divided into hypertensive group and non-hypertensive group. According to the degree of coronary artery lesions, the patients were divided into group A1 （normal coronary artery）, group A2 （lesions in a single branch）, group A3 （lesions in two branches）, and group A4 （lesions in three branches）. Coronary angiography was performed for all patients. The Gensini scores of coronary artery disease and number of vessels were used to analyze the severity of coronary artery disease. Brachial blood pressure was accurately measured before and after surgery, and 24-hour ambulatory blood pressure monitoring was performed for all patients after surgery. Results Compared with the non-hypertensive group, the hypertensive group had a significant increase in the probability of lesions in three branches of the coronary artery （P〈 0.05）, as well as significant increases in blood pressure and pulse pressure （P〈0.05）. Compared with those with normal coronary artery, the patients with coronary artery stenosis had significant increases in blood pressure and pulse pressure （P〈0.05）. Conclusion In patients with coronary heart disease, pulse pressure is a major cause of coronary artery stenosis and disease progression. Therefore, 24-hour ambulatory blood pressure monitoring has an important clinical value in such patients.