H型高血压患者反应性充血指数与冠心病的关系研究

The association of reactive hyperemia index with coronary heart disease in patients with H-type hypertension

目的探讨H型高血压患者反应性充血指数(RHI)与冠心病的关系。方法经冠状动脉造影(CAG)检查的H型高血压患者186例,按照RHI水平分为低RHI组(RHI<1.67,78例)和高RHI组(RHI≥1.67,108例)。比较两组一般临床资料、冠心病检出率和冠状动脉病变情况。结果与高RHI组比较,低RHI组收缩压、脉压、LDL-C、尿酸、同型半胱氨酸(Hcy)、超敏C反应蛋白(hs-CRP)、WBC、空腹血糖水平较高,两组比较差异均有统计学意义(均P<0.05)。低RHI组冠心病比例、Gensini积分[79.49%、(26.14±8.39)分]均高于高RHI组[61.11%、(18.87±5.70)分],冠状动脉病变支数亦多于高RHI组,差异均有统计学意义(χ^2/t/Z=7.127、7.852、2.748,均P<0.01)。多因素logistic回归分析提示RHI<1.67是H型高血压患者发生冠心病的独立预测因素(OR=2.318,95%CI:1.481~4.110,P<0.01)。结论 H型高血压患者RHI与冠心病之间存在着关联性。

Objective To investigate the association of reactive hyperemia index(RHI) with coronary heart disease in patients with H-type hypertension. Methods 186 patients with H-type hypertension who underwent coronary angiography(CAG) examination were enrolled and divided into low RHI group(RHI<1.67, 78 cases) and high HRI group(RHI≥1.67,108 cases) according to RHI level. General clinical data, the incidence and severity of coronary lesion were compared between the two groups. Results Compared with high HRI group, systolic blood pressure, pulse pressure, LDL-C, uric acid, homocysteine(Hcy), hypersensitive C-reactive protein(hs-CRP), WBC and fasting blood glucose were significantly higher in low RHI group(P<0.05 or 0.01). The percentage of coronary heart disease, Gensini score were significantly higher in low HRI group [79.49%,(26.14±8.39)score] than in high HRI group [61.11%、(18.87±5.70) score]( all P<0.01).The number of lesion vessels was significantly higher in low RHI group than high RHI group(χ^2=7.127、t=7.852、Z=2.748, all P<0.01). Multivariate logistic regression equation indicated that RHI<1.67 was an independent predictor of coronary heart disease in patients with H-type hypertension(OR=2.318, 95%CI:1.481~4.110, P<0.01). Conclusion There is relevance between RHI and coronary artery disease in patients with H-type hypertension.