血压晨峰对未达临界病变隐匿性冠心病的影响

Influence of morning blood pressure surge on occult coronary heart disease with subcritical lesions

目的探讨血压晨峰对未达临界病变隐匿性冠心病(50%≤冠脉狭窄程度<70%)的影响。方法选取未达临界病变的隐匿性冠心病患者92例,所有患者均无临床心绞痛症状,均经冠脉造影检查提示冠脉主要分支狭窄≥50%且<70%。术后1周行动态血压及动态心电图同步检查,将血压晨峰≥23.6 mm Hg的患者设为血压晨峰组(54例),血压晨峰<23.6 mm Hg的患者设为非血压晨峰组(38例)。观察血压晨峰对不同组别患者心电图ST段的影响。结果血压晨峰组患者清晨收缩压、舒张压及ST段压低患者占比均高于非血压晨峰组且差异有统计学意义(P <0.05)。结论血压晨峰可引起未达临界病变的隐匿性冠心病患者心电图ST段压低,因此控制血压晨峰对这类患者具有重要意义。

Objective To investigate the influence of morning blood pressure surge(MBPS)on occult coronary heart disease(CHD,50%≤coronary stenosis degree<70%)without critical lesion.Methods Ninety-two occult CHD patients with subcritical lesions were selected.All the patients had no clinical symptom of angina;coronary angiography(CAG)examination implies that the stenosis degree of the main coronary artery was≥50%and<70%.Ambulatory blood pressure and ambulatory electrocardiography examination were synchronously performed one week after surgery.Patients with MBPS≥23.6 mm Hg were set as MBPS group(54 cases)while those with MBPS<23.6 mm Hg were set as the non-MBPS group(38 cases).The influence of MBPS on the ST-segment of the ECG of patients in different groups was observed.Results The early morning systolic and diastolic blood pressure,and the proportion of patients with depressed ST-segment in the MBPS group are higher than those in the non-MBPS group,with statistically significant differences(P<0.05).Conclusion MBPS could give rise to ST-segment depression of ECG in occult CHD patients with subcritical lesions,and therefore it is important for these patients to control MBPS.