原发性高血压患者不同血压参数与冠状动脉病变的相关性分析

Correlation between different blood pressure parameters and coronary artery lesion in patients with primary hypertension

目的 探讨原发性高血压患者的不同血压参数与原发性高血压患者冠状动脉病变的相关性.方法 选取确诊为原发性高血压且行冠状动脉造影检查患者103例,其中至少1支主要分支狭窄≥50％者55例,为冠心痛组;冠状动脉正常者48例,为对照组.于相同条件下行动脉功能检查测定两组无创中心动脉压及24h动态血压监测.结果 两组患者夜间外周收缩压均值、全天外周脉压、无创中心动脉收缩压（CSAP）、无创中心动脉脉压（CPP）、夜间血压（收缩压及舒张压）均值下降率（MBPF）、无创中心动脉收缩压分数（CFSP）、无创中心动脉舒张压分数（CFDP）、无创中心脉压指数（CPPI）比较差异均有统计学意义（P均＜0.05）,经Logistic逐步回归分析得出,无创CPP、CPPI、CFSP升高及CFDP下降是冠心病的危险因素（P＜0.05）.结论 无创CPP、CPPI、CFSP升高及CFDP下降是冠状动脉病变的危险因素,可作为高血压患者冠状动脉病变程度早期预测的敏感指标.

Objective To investigate the correlation between different noninvasive blood pressure parameters and coronary artery lesion in primary hypertensive patients.Methods A total of 103 primary hypertension patients who had experienced coronary angiography （CAG） were divided into coronary heart disease group （at least 1 major branch stenosis ≥50%,n =55） and normal coronary group （all coronaries were normal,n =48）.And the noninvasive arterial pressure and the 24 h ambulatory blood pressure of the two groyps were monitored by artery function test under the same condition.Results Between the two groups,the mean peripheral systolic blood pressure during night,the whole day peripheral pulse pressure,the mean blood pressure fall rate （MBPF） during night and the noninvasive central aortic systolic blood pressure （CSAP）,central aortic pulse pressure （CPP）,central aortic pulse pressure index （CPPI）,noninvasive fraction of central aortic systolic pressure （CFSP）,noninvasive fraction of central aortic diastolic pressure （CFDP） were significantly different （P 〈 0.05）.The Logistic regression analysis showed that the increases of the noninvasive CPP,CPPI,CFSP and the decrease of CFDP were the risk factors of coronary heart disease （P 〈 0.05）.Conclusions The increases of the noninvasive CPP,CPPI,CFSP and the decrease of the CFDP are the risk factors of coronary artery disease,which can be used as the sensitive indexes of early prediction for the primary coronary artery lesion in hypertensive patients.