动态血压参数与冠状动脉病变严重程度的相关性研究

Study on the correlation between ambulatory blood pressure parameters and severity of coronary lesion

目的:探讨不同动态血压参数与冠状动脉(冠脉)病变严重程度的相关性。方法:可疑冠心病病人322例,均行24 h动态血压监测和冠脉造影,按照冠脉造影结果分为冠脉正常组(n=85)、单支病变组(n=91)、双支病变组(n=77)和三支病变组(n=69),比较各组动态血压参数。结果:单支、双支和三支病变病人的24 h平均收缩压(24 hASBP)、24 h平均脉压(24 hAPP)、白天平均脉压(dAPP)、夜间平均收缩压、夜间平均脉压(nAPP)、均高于冠脉正常组(P<0.05~P<0.01)。与杓型血压模式比较,非杓型、反杓型、超杓型血压模式的病变支数(双支、三支)均明显高于杓型血压模式(P<0.01);同一血压模式下病变支数比例分布,杓型血压模式:正常>单支>双支>三支(P<0.01),反杓型血压模式的病变支数:三支>双支>单支>正常(P<0.01)。logistic多元回归分析显示,吸烟、糖尿病、24 hASBP、dASBP、24 hAPP、dAPP、夜间平均脉压均为冠心病的危险因素(P<0.05~P<0.01)。结论:动态血压模式与高血压靶器官损害的严重程度具有相关性。

Objective:To study the correlation between ambulatory blood pressure parameters and severity of coronary lesion.Methods:The 24 h ambulatory blood pressure and coronary angiography in 322 patients suspected by coronary heart disease were detected.According to the results of coronary angiography,the patients were divided into the normal coronary artery group(85 cases)and single vessel lesion group(91 cases),two branches lesion group(77 cases)and three branches lesion group(69 cases).The ambulatory blood pressure parameters were compared among 4 groups.Results:The 24-h ASBP,24-h APP,dAPP,nASBP and nAPP in patients with single,double and three-vessel lesions were significantly higher than those in patients with normal coronary artery(P<0.05 to P<0.01).The number of lesion branches(double and three branches)in non-dipper,reverse dipper and super-dipper blood pressure patterns patients were higher than those in dipper blood pressure patterns patients(P<0.01).Under the arytenoid blood pressure pattern,the proportional distribution of normal,single,double and three branches lesion gradually decreased(P<0.01).Under the inverting arytenoid blood pressure pattern,the proportional distribution of three,double,single and normal branches lesion gradually decreased(P<0.01).The results of multiple logistic regression analysis showed that the smoking,diabetes,24 hASBP,dASBP,24 hAPP,dAPP,and nAPP were the risk factors for coronary heart disease(P<0.05 to P<0.01).Conclusions:The ambulatory blood pressure pattern is significantly correlated with the severity of hypertensive target organ damage.