老年高血压患者脉压及脉压指数与冠心病相关性研究

On Correlation between Pulse Pressure,Pulse Pressure Index and Coronary Heart Disease in Elderly Patients with Hypertension

目的探讨老年高血压患者脉压(PP)、脉压指数(PPI)与冠心病的相关性.方法以108例老年高血压患者为研究对象,行24 h动态血压监测、冠脉造影检查,记录舒张压(DBP)、收缩压(SBP)情况,计算PP,PPI,并通过Gensini积分评价冠脉严重程度.根据冠脉造影检查结果将患者分为冠心病组与正常组,比较两组患者平均血压(MBP)、PP、PPI值;另根据PPI值将患者分为A(≤0.4),B(0.4～0.5),C(0.5～0.6),D(>0.6) 4组,比较各组冠心病发生率及Gensini积分情况;通过Spearman相关性分析PP,PPI与冠心病、Gensini积分的相关性.结果冠心病组PP,PPI分别为(78.21±8.36) mm Hg、(0.53±0.10),均显著高于正常组的(66.43±7.58) mm Hg、(0.43±0.15),差异具有统计学意义(P<0.05);冠心病发生率、Gensini积分随PPI值升高而上升(P<0.05),A组冠心病发生率、Gensini积分均显著低于其他3组(P<0.05),D组Gensini积分显著高于B组(P<0.05); Spearman相关性分析显示:PP,PPI分别与冠心病、Gensini积分显著正相关(P<0.05).结论 PP,PPI与老年高血压患者冠心病发生有关,特别是PPI,PPI值越大,冠心病发生率越高,冠脉病变越严重.

Objective To explore the correlation between pulse pressure （PP）,pulse pressure index （PPI） andcoronary heart disease （CHD） in elderly patients with hypertension. Method A total of 108 elderly patientswith hypertension were enrolled in the study. All the patients underwent 24-hour ambulatory blood pressuremonitoring and coronary angiography. The diastolic pressure （DBP） and systolic pressure （SBP） were recorded,and PP and PPI were calculated. The severity of coronary artery lesions was evaluated by Gensini score.According to the results of coronary angiography,the patients were divided into CHD group and normal group. Themean blood pressure （MBP）,PP and PPI were compared between the two groups. According to the PPI value,the patients were divided into four groups A（≤0. 4）,B（0. 4 ~ 0. 5）,C （0. 5 ~ 0. 6） and D（ 〉0. 6） . Theincidence of CHD and Gensini score were compared among the groups. The correlation between PP,PPI andCHD,Gensini score was analyzed by Spearman correlation analysis. Results PP and PPI of CHD group （78. 21±8. 36） mmHg,（0. 53±0. 10） were significantly higher than those of the normal group （66. 43±7. 58） mmHg,（0. 43±0. 15） （P〈0. 05）. The incidence of CHD and Gensini score increased with the increase of PPI （P〈0. 05）. The incidence of CHD and Gensini score in group A were significantly lower than those in the other threegroups （P〈0. 05）,and the Gensini score in group D was significantly higher than that in group B （P〈0. 05）.Spearman correlation analysis showed that PP and PPI were significantly positively correlated with CHD andGensini score （P〈0. 05）. Conclusion PP and PPI are related to the occurrence of CHD in elderly patientswith hypertension. The larger PPI and PPI values are,the higher the incidence of CHD is and the more seriouscoronary lesions are.