脉压、脉压指数的测定在冠状动脉粥样硬化性心脏病并缺血性卒中患者冠状动脉病变、预后评估中的作用分析

Role of Pulse Pressure and Pulse Pressure Index in Evaluating Coronary Artery Lesions and Prognosis in Patients with Coronary Heart Disease and Ischemic Stroke

目的探讨测定24 h动态脉压(24 h pulse pressure,24hPP)、24 h动态脉压指数(24 h pulse pressure index,24hPP在冠状动脉粥样硬化性心脏病(简称冠心病)并缺血性卒中患者冠状动脉病变、预后评估中的作用。方法选取2017年3月至2019年3月收治的127例冠心病并缺血性卒中患者作为观察组,同期治疗的131例单纯冠心病组为对照组。对比两组24hPP、24hPPI及Gensisi评分;Pearson直线相关分析24hPP、24hPPI与Gensisi评分的相关性;随访2年,了解患者预后情况;采用logistic回归分析影响冠心病并缺血性卒中患者预后死亡的相关危险因素;绘制受试者工作特征曲线评估联合24hPP、24hPPI检测对冠心病并缺血性卒中患者预后的预测价值。结果观察组24hPP、24hPPI及Gensisi评分均高于对照组,比较差异具有统计学意义(P<0.05)。Pearson直线相关分析显示24hPP、24hPPI与Gensisi评分呈正相关性(P<0.05)。观察组在随访2年内有42例患者死亡,生存率为66.93%(85/127)。吸烟、高血压、糖尿病、收缩压异常升高、24hPP异常升高、24hPPI异常升高为影响冠心病并缺血性卒中患者预后死亡的相关危险因素(P<0.05)。24hPP、24hPPI单一指标检测敏感度、特异度、曲线下面积均低于二者联合检测(P<0.05)。结论24hPP、24hPPI与冠心病并缺血性卒中患者冠脉病变严重程度、预后有关,二者对冠心病并缺血性卒中患者预后具有较高的预测价值。

Objective To determine the role of 24-hour pulse pressure(24hPP)and 24-hour pulse pressure index(24hPP in coronary lesions and prognostic evaluation in patients with coronary heart disease and ischemic stroke.Methods A total of 127 patients with coronary heart disease and ischemic stroke admitted to our hospital from March 2017 to March 2019were selected as observation group,and 131 patients with simple coronary heart disease treated in our hospital during the same period were taken as control group.The 24hPP,24hPPI and Gensisi scores were compared between the two groups.Pearson linear correlation was used to analyze the correlation between 24hPP,24hPPI and Gensisi scores.All the patients were followed up for 2 years to understand the prognosis.Logistic regression was used to analyze the risk factors affecting the prognosis and death of patients with coronary heart disease and ischemic stroke.The receiver operating characteristic(ROC)curve was drawn to evaluate the combined detection of 24hPP and 24hPPI in predicting the prognosis of patients with coronary heart disease and ischemic stroke.Results The 24hPP,24hPPI and Gensisi scores of the observation group were significantly higher than those of the control group(P<0.05).Pearson linear correlation analysis showed that 24hPP and 24hPPI were positively correlated to Gensisi score(P<0.05).Among the 127 patients in the observation group,42 died within 2 years of follow-up,and the survival rate was 66.93%(85/127).Smoking,hypertension,diabetes,abnormally elevated SBP,abnormally elevated 24hPP,and abnormally elevated 24hPPI were risk factors affecting the prognosis and death of patients with coronary heart disease and ischemic stroke(P<0.05).The sensitivity,specificity,and AUC of a single index of 24hPP or 24hPPI were lower than those of the combined detection of the two(P<0.05).Conclusions 24hPP and 24hPPI are related to the severity and prognosis of coronary artery disease in patients with coronary heart disease and ischemic stroke.Both have high predictive value for the prognosis of patients with coronary heart disease and ischemic stroke.