老年慢性稳定型心绞痛患者餐后低血压与冠状动脉病变程度的关系研究

Correlation between postprandial hypotension and severity of coronary artery disease in elderly patients with chronic stable angina pectoris

目的探讨老年慢性稳定型心绞痛患者餐后低血压(PPH)与冠状动脉病变程度的关系。方法按照入院后是否存在PPH,将2016年2月至2019年2月衢州市第三医院收治的158例老年慢性稳定型心绞痛患者分为PPH组(69例)和非PPH组(89例),比较两组患者临床资料、三餐前后血压变化、冠状动脉病变程度,分析PPH与冠状动脉病变程度的关系。结果与非PPH组比较,PPH组血肌酐、甘油三酯、超敏C反应蛋白水平以及早、晚餐前收缩压及其下降幅度均明显升高,差异均有统计学意义(均P<0.05)。PPH组冠状动脉病变支数为(2.42±0.81)支,明显多于非PPH组的(2.16±0.75)支(P<0.05);Gensini评分为(46.54±15.54)分,明显高于非PPH组的(28.96±13.70)分(P<0.05);多元logistic回归分析显示,PPH是冠状动脉多支病变的独立危险因素(OR=2.176,95%CI:1.764~5.329,P<0.05)。结论伴有PPH现象的老年慢性稳定型心绞痛患者冠状动脉病变常较严重。

Objective To investigate the correlation between postprandial hypotension(PPH)and the severity of coronary artery lesion in elderly patients with chronic stable angina(CSA).Methods 158 elderly patients with CSA were enrolled in Quzhou Third Hospital from February 2016 to February 2019.They were divided into PPH group(n=69)and non PPH group(n=89)according to whether there was PPH after admission.The clinical data,the blood pressure changes pre-and post-diet,the number of CAE and Gensini score were compared between the two groups.Results The levels of serum creatinine,triglyceride(TG),and high sensitivity C-reactive protein(hs-CRP)were significantly higher in PPH group than in non PPH group(all P<0.05).Systolic blood pressure(SBP)before breakfast and supper and the decrease of postprandial SBP were significantly higher in PPH group than in non PPH group(all P<0.05).The number of diseased coronary arteries[(2.42±0.81)vs.(2.16±0.75)]and Gensini score[(46.54±15.54)vs.(28.96±13.70)]were significantly higher in PPH group than in non PPH group(all P<0.05).Multivariate logistic regression analysis showed that PPH was an independent risk factor for multi-vessel coronary disease(OR=2.176,95%CI:1.764-5.329,P<0.05).Conclusion Coronary artery disease is often more serious in elderly patients with CSA complicated with PPH.