老年慢性稳定型心绞痛患者血压变异性与运动耐量的相关性

Correlation between blood pressure variability and exercise tolerance in elderly patients with chronic stable angina pectoris

目的观察老年慢性稳定型心绞痛患者血压变异性与运动耐量,并分析血压变异性与运动耐量的相关性。方法回顾性选取解放军联勤保障部队第940医院2017年1月~2019年12月期间288例老年慢性稳定型心绞痛患者临床资料,根据加拿大心血管病学会(CCS)心绞痛分级进行分组,A组(CCSⅠ级98例)、B组(CCSⅡ级92例)、C组(CCS分级Ⅲ级98例)。记录并对比3组血压变异性[24 h收缩压标准差(24hSSD)、白天收缩压标准差(dSSD)、夜间收缩压标准差(nSSD)、24 h舒张压标准差(24hDSD)、白天舒张压标准差(dDSD)、夜间舒张压标准差(nDSD)]与运动耐量[运动至ST段压低1.0 mm时间、运动至心绞痛发作时间、运动总时间、运动当量],分析上述指标之间的相关性。结果A组dSSD、nSSD、24hSSD、dDSD、nDSD、24hDSD最低,后由低至高依次为B组、C组,差异有统计学意义(P<0.05)。A组ST段压低1.0 mm时间、运动至心绞痛发作时间及运动总时间均较长,运动当量较高,后由高至低依次为B组、C组,差异有统计学意义(P<0.05)。经双变量Pearson直线检验分析显示,dSSD、nSSD、24hSSD、dDSD、nDSD、24hDSD分别与ST段压低1.0 mm时间及运动当量均呈负相关(r<0,P<0.05);与运动至心绞痛发作时、运动总时间无显著相关性(P>0.05)。结论老年慢性稳定型心绞痛患者血压变异性与运动耐量密切相关,临床可考虑通过一系列合理干预帮助老年慢性稳定型心绞痛患者运动耐量,可能对患者降低血压变异幅度有积极意义。

Objective To observe blood pressure variability and exercise tolerance in elderly patients with chronic stable angina pectoris,and to analyze the correlation between blood pressure variability and exercise tolerance.Methods A retrospective analysis was performed.Clinical data of 288 elderly patients with chronic stable angina pectoris from January 2017 to December 2019 in our hospital were collected.Then divided them according to the Canadian Society of Cardiovascular Disease(CCS)angina pectoris into group A(98 cases of CCS gradeⅠ),group B(92cases of CCS grade II),group C(98 cases of CCS grade III).Recorded and compared the blood pressure variability in 3 groups[24h systolic pressure standard deviation(24hSSD),daytime systolic pressure standard deviation(dSSD),night systolic pressure standard deviation(nSSD),24h diastolic pressure standard deviation(24hDSD),daytime diastolic pressure standard deviation(DDSD),standard deviation of diastolic blood pressure at night(nDSD)]and exercise tolerance[time from exercise to ST segment depression 1.0 mm,exercise to angina attack time,total exercise time,exercise equivalent],analyzed the correlation between the above indicators.Results In three groups,group A had the lowest dSSD,nSSD,24hSSD,dDSD,nDSD,and 24hDSD,followed by group B and group C ranking from low to high(P<0.05);in three groups,group A had ST segment depression by 1.0mm,exercise to angina pectoris attack time and total exercise time were longer,exercise equivalent was higher,followed by group B and group C ranking from high to low(P<0.05);analysis of bivariate Pearson linear test showed that dSSD,nSSD,24hSSD,DDSD,nDSD and 24hDSD were negatively correlated with ST segment depression 1.0mm time,exercise equivalent(r<0,P<0.05).Conclusion Blood pressure variability in elderly patients with chronic stable angina pectoris is closely related to exercise tolerance.Clinically,a series of reasonable interventions can be considered to help exercise tolerance in elderly patients with chronic stable angina pectoris,which may have a positive significance in reducing the blood pressure variation.