血压变异性与冠心病患者冠状动脉非钙化斑块负荷的相关性研究

Correlation between blood pressure variability and non calcified plaque load of coronary artery in patients with coronary artery heart disease

目的探讨冠心病患者血压变异性与冠状动脉非钙化斑块负荷的关联性。方法选取2017年1月至2019年1月于中国人民解放军陆军军医大学第二附属医院就诊的110例冠心病患者作为研究对象,根据是否存在高血压将其分为高血压组(68例)和非高血压组(42例),比较两组患者血脂指标、血压变异性及冠状动脉非钙化斑块负荷的差异,并分析血压变异性与冠状动脉非钙化斑块负荷间的相关性。结果两组患者总胆固醇、甘油三酯、高密度脂蛋白和低密度脂蛋白水平比较差异均无统计学意义(均P>0.05)。高血压组患者24 h平均收缩压、24 h平均舒张压、24 h收缩压变异性、24 h舒张压变异性、冠状动脉非钙化斑块负荷和总斑块负荷均显著高于非高血压组(均P<0.001)。Pearson线性相关分析显示,冠状动脉非钙化斑块负荷和总斑块负荷与24 h收缩压变异性、24 h舒张压变异性、高血压病程、左心室后壁厚度均呈正相关(均P<0.05)。结论血压变异性增大可能是冠心病患者冠状动脉非钙化斑块负荷的影响因素,在冠心病的治疗中应注意控制血压变异性水平。

Objective To investigate the relationship between blood pressure variability and non calcified plaque load in patients with coronary artery heart disease.Method From January 2017 to January 2019,110 patients with coronary artery heart disease diagnosed and treated in Second Affiliated Hospital of Army Medical University of the Chinese People's Liberation Army were selected as the research objects.According to whether there was hypertension,they were divided into hypertension group(n=68)and non-hypertension group(n=42).The differences of blood lipid indexes,blood pressure variability and non calcified plaque load between the two groups were compared,and the correlation between blood pressure variability and non calcified plaque load were analyzed.Result There were no significant difference in total cholesterol,triglyceride,high density lipoprotein and low density lipoprotein between the two groups(all P>0.05).The 24 h mean systolic pressure,24 h mean diastolic pressure,24 h systolic pressure variability,24h diastolic pressure variability,coronary artery non calcified plaque load and total plaque load in hypertension group were significantly higher than those in non-hypertension group(all P<0.001).Pearson linear correlation analysis showed that coronary artery non calcified plaque load and total plaque load were positively correlated with 24 h systolic pressure variability,24 h diastolic pressure variability,hypertension course,and left ventricular posterior wall thickness(all P<0.05).Conclusion The increase of blood pressure variability may be the influencing factor of non calcified plaque load in coronary artery heart disease,so we should pay attention to control the level of blood pressure variability in the treatment of coronary artery heart disease.