原发性高血压患者血压变异性与冠脉病变程度的相关性

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

目的探讨原发高血压患者血压变异性与冠脉病变的严重程度间的相关性。方法选择2017年1月至2019年2月诊治的100例原发性高血压患者为回顾性分析的对象,根据冠脉造影检查结果进行分组,即冠脉阳性组和冠脉阴性组。对患者血压变异性、心肌缺血负荷以及冠脉病变Gensini评分三者的关系进行分析。结果冠脉阳性组24 h收缩压、日间收缩压、24 h舒张压、夜间收缩压、24 h舒张压变异系数(24 h DCV)等各指标均显著高于冠脉阴性组(P<0.05)。冠脉阳性组当中各组心肌缺血总负荷(TIB)、24 h收缩压变异系数(24 h SCV)、24 h DCV等指标比较,差异均有统计学意义(P<0.05),重度组各指标显著高于轻度组和中度组,而中度组各指标显著高于轻度组(P<0.05)。24 h SCV、日间收缩压变异系数(dSCV)和TIB指标具有正相关关系(P<0.05),24 h DCV、日间舒张压变异系数(dDCV)以及夜间舒张压变异系数(nDCV)和夜间收缩压变异系数(nSCV)和TIB指标并无相关性(P>0.05)。24 h SCV、dSCV以及nSCV和冠脉病变冠状动脉造影评分评估系统(Gensini评分)具有正相关关系(P<0.05),24 h DCV、dDCV以及nDCV和冠脉病变Gensini评分并无相关性(P>0.05)。结论原发性高血压患者的血压变异性和冠脉病变程度具有相关性,其中24 h SCV、dSCV以及nSCV指标均是患者冠脉病变的重要独立因素。

Objective To investigate the relationship between blood pressure variability and the severity of coronary lesions in patients with primary blood pressure.Methods A total of 100 patients with essential hypertension who were diagnosed and treated from January 2017 to February 2019 were retrospectively analyzed.According to the results of coronary angiography,the patients were divided into positive coronary artery group and negative coronary artery group.The relationship among blood pressure variability,myocardial ischemic load and Gensini score of coronary artery disease was analyzed.Results The 24-hour systolic blood pressure,the levels of day systolic blood pressure,24-hour diastolic blood pressure,night systolic blood pressure,24-hour diastolic blood pressure variation coefficient (24?hour DCV) in the positive coronary artery group were significantly higher than those in the negative coronary artery group (P < 0.05).The total ischemic load (TIB),24-hour systolic pressure variability (24-hour SCV),24-hour DCV and other indicators in the positive coronary artery subdivided groups were significantly different (P<0.05).The indicators in the severe group were significantly higher than those in the mild group and the moderate group,while those in the moderate group were significantly higher than those in the mild group (P < 0.05).24 h SCV,diurnal systolic pressure variability (dSCV) were positively correlated with TIB (all P < 0.05),but 24 h DCV,diurnal diastolic pressure variability (dDCV),nocturnal diastolic pressure variability (nDCV),nocturnal systolic pressure variability (nSCV) were not correlated with TIB (all P > 0.05).There was positive correlation of 24 h SCV,dSCV,nSCV with Gensini score (P<0.05),but no correlation of 24 h DCV,dDCV,nDCV with Gensini score (P > 0.05).Conclusions The blood pressure variability is correlated with the degree of coronary artery lesion in patients with essential hypertension.24 h SCV,dSCV and nSCV are important independent factors for coronary artery lesion.