稳定性冠状动脉疾病合并高血压患者的LVMI与冠脉病变程度的相关性

Correlation between left ventricular mass index and coronary lesion degree in patients with stable coronary artery disease complicated with hypertension

目的探讨稳定性冠状动脉疾病合并高血压患者的左心室重量指数(LVMI)与冠脉病变程度的相关性。方法回顾性分析2020年9月至2021年10月咸阳市第一人民医院收治的84例稳定性冠状动脉疾病合并高血压患者的临床资料。所有患者入院后均行心脏超声检查,按照LVMI将所有患者分为A组(LVMI≥115.71 g/m^(2))41例和B组(LVMI<115.71 g/m^(2))43例;同时将所有患者按照冠脉Gensini积分分为高分组(得分>40分)21例、中分组(得分20~40分)48例、低分组(得分<20分)15例。比较A组和B组患者的冠脉病变支数、总胆固醇(TC)、空腹血糖(FPG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、甘油三酯(TG)、血清肌酐(Scr)、血清B型脑钠肽(BNP)水平和冠脉Gensini积分差异;比较不同冠脉Gensini积分患者的LVMI水平;采用Pearson相关性分析法分析冠脉Gensini积分与生化指标的相关性;采用多元线性回归法分析影响冠脉Gensini积分的相关因素。结果A组和B组患者的TC、FPG、LDL-C、HDL-C水平比较差异均无统计学意义(P>0.05);A组患者的TG、Scr、BNP水平分别为(1.72±0.36)mmol/L、(79.43±16.21)μmol/L、(421.57±105.34)pg/mL,明显高于B组的(1.41±0.29)mmol/L、(74.23±14.71)μmol/L、(313.29±95.45)pg/mL,差异均具有统计学意义(P<0.05);A组患者的冠脉Gensini积分为(38.41±12.32)分,明显高于B组的(21.18±7.21)分,差异有统计学意义(P<0.05);A组患者1支冠脉病变发生的比例明显低于B组,3支冠脉病变发生的比例明显高于B组,差异均具有统计学意义(P<0.05);三组不同冠脉Gensini积分组患者间的LVMI水平比较,冠脉Gensini积分高分组患者的LVMI明显高于中分组及低分组,中分组患者的LVMI明显高于低分组,差异均有统计学意义(P<0.05);经多元线性回归分析结果显示,LVMI、SBP、TG、BNP、Scr是冠脉Gensini积分增高的相关危险因素(P<0.05)。结论稳定性冠状动脉疾病合并高血压患者的LVMI升高与冠脉的病变程度密切相关。

Objective To investigate the correlation between left ventricular mass index(LVMI)and coronary lesion degree in patients with stable coronary artery disease complicated with hypertension.Methods The clinical data of 84 patients with stable coronary artery disease complicated with hypertension admitted to Xianyang First People's Hospital from September 2020 to October 2021 were retrospectively analyzed.All patients underwent cardiac ultrasound after admission.According to LVMI,the patients were divided into group A(LVMI≥115.71 g/m2,n=41)and group B(LVMI<115.71 g/m2,n=43).At the same time,the patients were divided into high score group(score>40 points,n=21),medium score group(score 20 to 40 points,n=48),and low score group(score<20 points,n=15)according to coronary Gensini score.The number of coronary artery lesions,total cholesterol(TC),fasting blood glucose(FPG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),triglyceride(TG),serum creatinine(SCR),serum B-type brain natriuretic peptide(BNP)levels,and coronary Gensini scores were compared between group A and group B.The levels of LVMI in patients with different coronary Gensini scores were compared.Pearson correlation analysis was used to analyze the correlation between coronary Gensini score and biochemical indexes.Multiple linear regression was used to analyze the associated factors affecting coronary Gensini scores.Results There was no significant difference in the levels of TC,FPG,LDL-C,and HDL-C between group A and group B(P>0.05).The levels of TG,Scr,and BNP in group A were(1.72±0.36)mmol/L,(79.43±16.21)μmol/L,(421.57±105.34)pg/mL,which were significantly higher than(1.41±0.29)mmol/L,(74.23±14.71)μmol/L,(313.29±95.45)pg/mL in group B(P<0.05).The coronary Gensini score in group A was(38.41±12.32)points,which was significantly higher than(21.18±7.21)points in group B(P<0.05).The incidence of one coronary artery lesion in group A was significantly lower than that in group B,and the incidence of three coronary artery lesions was significantly higher than that in group B,with statistically significant differences(P<0.05).Comparison of LVMI levels among the three groups with different coronary Gensini scores showed that LVMI in patients with high coronary group was significantly higher than that in medium score group and low score group,and LVMI in patients with medium score group was significantly higher than that in low score group,with statistically significant differences(P<0.05).The results of multiple linear regression analysis showed that LVMI,SBP,TG,BNP,and Scr were the related factors for the increase of coronary Gensini score(P<0.05).Conclusion The increase of LVMI in patients with stable coronary artery disease complicated with hypertension is closely related to the degree of coronary artery disease.