原发性高血压患者对称动态动脉硬化指数与冠心病的关系研究

Relationship Between Symmetrical Ambulatory Arterial Stiffness Index and Coronary Heart Disease in Patients with Primary Hypertension

目的探讨原发性高血压患者对称动态动脉硬化指(S-AASI)数与冠心病的关系。方法选取2015年1月—2017年9月石河子大学医学院第一附属医院心内科住院的原发性高血压患者438例为研究对象,获取24h动态血压(ABPM)监测指标和冠状动脉造影结果,依据冠脉狭窄程度分为对照组(无狭窄)、冠脉硬化组(0~50%)和冠心病组(≥50%),比较三组患者的基本资料和ABPM值。分析原发性高血压患者发生冠心病的影响因素,采用ROC曲线评估S-AASI对冠心病(CHD)的预测价值。结果与对照组比较冠心病组年龄、吸烟比、日间收缩压标准差(dSBPSD)、24h收缩压标准差(24SBPSD)更高,夜间舒张压均值(nDBPM)更低(P<0.05);随冠状动脉狭窄程度的加重,S-AASI明显升高(P<0.01);logistic回归分析显示:吸烟、S-AASI是原发性高血压患者发生冠心病的独立危险因素(P<0.01);S-AASI诊断原发性高血压患者发生冠心病的ROC曲线下面积(AUC)为0.772(0.716~0.828)。结论S-AASI对原发性高血压患者诊断冠心病的发生有一定价值,可作为判断冠状动脉硬化的重要指标。

Objective To investigate the relationship between symmetrical ambulatory arterial stiffness index(S-AASI)and coro? nary heart disease(CHD)in patients with primary hypertension. Methods A total of 438 patients with primary hypertension admitted to the Department of Cardiology,The First Affiliated Hospital of Shihezi University School of Medicine from January,2015 to September,2017 were selected to get 24hour ambulatory blood pressure monitoring(ABPM)indicators and coronary angiography results. Ac? cording to the degree of coronary artery stenosis,patients were divided into control group,coronary arteriosclerosis group and CHD group. Basic data and ABPM indicators of three groups were compared,influencing factors of CHD were analyzed,and value of SAASI for CHD using ROC curve were predicted. Results Compared with the control group,the age,smoking ratio,daytime systolic blood pressure standard deviation(dSBP SD)and 24 hours systolic blood pressure standard deviation(24SBP SD)of CHD groups are higher,and the night diastolic blood pressure mean(n DBP M)is lower(P<0.05). S-AASI is significantly elevated with the severity of coronary artery stenosis(P<0.01). Smoking and S-AASI are independent risk factors for CHD by logistic regression. The area under the ROC curve(AUC)for the diagnosis of CHD is 0.772(0.716~0.828).Conclusion S-AASI has a certain value in the diagnosis of CHD in patients with primary hypertension,and can be used as an important indicator to judge coronary arteriosclerosis.