原发性高血压患者冠状动脉病变严重程度与其动态血压水平及血压类型的关系研究

Relationship between severity of coronary artery disease and dynamic blood pressure and blood pressure in patients with essential hypertension

目的探讨原发性高血压患者24 h动态血压的变化规律及其与动脉粥样硬化病变严重程度的关系。方法随机选取2015年5月至2017年5月在我院进行冠脉造影的原发性高血压患者90例,依据冠脉造影结果将这些患者分为单支病变组、双支病变组和多支病变组,检测比较三组患者的24 h动态血压及血压类型。结果三组患者日间平均收缩压及舒张压、24 h平均舒张压比较差异无统计学意义(P>0.05);三组患者夜间收缩压、夜间舒张压比较差异具有统计学意义(P<0.05),且单支病变组<双支病变组<多支病变组。昼夜平均收缩压单支病变组明显低于双支病变组和多支病变组(P<0.05)。三组患者的昼夜收缩压变化、昼夜舒张压变化比较差异具有统计学意义(P<0.05),血压水平变化单支病变组>双支病变组>多支病变组(P>0.05)。三组患者杓型、深杓型、反杓型、非杓型血压类型的构成比比较差异有统计学意义(P>0.05),随着病变支数增多患者杓型、深杓型血压类型所占比例降低,反杓型、非杓型血压类型所占比例增加。结论不同冠状动脉病变严重程度的原发性高血压患者,其24 h动态血压水平和血压类型存在显著差异,患者冠脉病变的严重程度与其24 h动态血压水平和血压类型密切相关。

Objective To investigate the changes of 24h ambulatory blood pressure in patients with essential hypertension and its relationship with the severity of atheroselerotie lesions. Methods 90 patients with primary hypertension who underwent coronary angiography in our hospital from May 2015 to May 2017 were randomly divided into single-vessel disease group, Double-vessel disease group and multi-vessel disease group according to the results of coronary angiography. The 24h ambulatory blood pressure and blood pressure types of the three groups were compared. Results There were no significant differences in mean systolic blood pressure, mean diastolic blood pressure, and diurnal diastolic blood pressure between the three groups （P〉0.05）. The difference of nighttime systolic pressure and nighttime diastolic blood pressure between the three groups was statistically significant,blood pressure level in and single-vessel disease group 〈 double-vessel disease group 〈 multi-vessel disease group（P〈0.05）. The average systolic blood pressure in the single-vessel disease group was significantly lower than that in the double-vessel disease group and the multi-vessel disease group （P〈0.05）. The difference of diurnal systolic blood pressure and diurnal diastolic blood pressure between the three groups was statistically significant （P〈0.05） , blood pressure level in single-vessel disease group 〉 double-vessel disease group 〉 multi-vessel disease group （P〉0.05）. There were significant differences in the composition ratios of sputum type, squat type, ruminant type and non-sputum type blood pressure among the three groups （P〉0.05）. With the increase in the number of lesions, the proportion of sputum type and squat type blood pressure decreased, and the proportion of sputum type and non-sputum type blood pressure increased. Conclusion There was a significant difference in 24h ambulatory blood pressure and blood pressure type in patients with essential hypertension with severity of coronary artery disease. The severity of coronary artery disease was closely related to its 24h ambulatory blood pressure level and blood pressure type.