原发性高血压患者血压昼夜节律与冠心病及冠脉病变的相关性分析

Correlation Between Circadian Rhythm of Blood Pressure and Coronary Heart Disease and Coronary Artery Disease in Patients with Essential Hypertension

目的分析原发性高血压患者血压昼夜节律与冠心病及冠脉病变的相关性。方法选取我院就诊的160例原发性高血压患者,均拟行冠脉造影,同时给予24 h动态血压监测,按照结果将入选患者分为A组:杓型组23例,B组:反杓型组68例,C组:非杓型组60例,D组:超杓型组9例,并分别计算Gensini积分,分析血压昼夜节律与冠脉病变的关系。结果D组以日均收缩压升高为主(P<0.05)。B组以夜均收缩压升高为主,同时,其夜均舒张压高于A组及C组(P<0.05)。B组(98.5%)、C组(90%)冠心病检出率高于A组(56.5%)及D组(55.6%)(P<0.05)。D组、A组、C组、B组Gensini积分逐渐增大(P<0.05)。A组、D组以单支病变为主,C组以双支病变为主,B组以多支病变为主(P<0.05)。结论原发性高血压患者不同的血压昼夜节律对冠脉病变具有不同水平的影响。

Objective To analyze the correlation between circadian rhythm of blood pressure(BP)and coronary heart disease(CHD)and coronary artery disease(CAD)in patients with essential hypertension.Methods160 patients with essential hypertension who underwent coronary angiography(CAG)were selected to underwent 24 h ambulatory blood pressure monitoring.According to the results,enrolled patients were segmented into A:dipper group(n=23),B:reverse dipper group(n=68),C:non-dipper group(n=60)and D:super dipper group(n=9).Gensini scores were calculated according to coronary angiography results of each patient.To analyze the correlation between circadian rhythm of BP and CAD.Results The mean daytime systolic blood pressure(dSBP)in D group was mainly increased(P<0.05).The mean night systolic blood pressure(nSBP)in B group was mainly increased(P<0.05).At the same time,The mean night diastolic blood pressure(nDBP)of the B group were higher than that of the A and C groups(P<0.05).The detection rate of CHD in the B group(98.5%)and C group(90%)was higher than that in the A group(56.5%)and D group(55.6%)(P<0.05).The Gensini scoer of D group,A group,C group and B group increases gradually(P<0.05).The A group and D group were dominated by single-vessel CAD,the C group was dominated by double-vessel CAD,and the B group was dominated by multi-vessel CAD(P<0.05).Conclusion Different circadian rhythms of blood pressure in patients with essential hypertension have different levels of influence on coronary artery disease.