血压变异性对不稳定型心绞痛患者介入治疗后心肌损伤的影响

Effect of Blood Pressure Variability on Myocardial Injury in Patients with Unstable Angina After Interventional Therapy

目的 探讨血压变异性对不稳定型心绞痛患者介入治疗后心肌损伤的影响。方法 本研究为前瞻性研究,纳入2019年1月至2022年8月舞钢市人民医院收治的180例不稳定型心绞痛患者作为研究对象。于患者入院时检测血压变异性指标,所有患者均接受经皮冠状动脉介入(PCI)治疗,统计患者术后24 h心肌损伤发生情况,使用logistic回归分析检验血压变异性对不稳定型心绞痛患者介入治疗后心肌损伤的影响。结果 180例不稳定型心绞痛患者中有1例患者血运重建失败,有1例患者主动要求退出试验,最终以178例患者完成本项研究;178例不稳定型心绞痛患者中,有61例患者发生心肌损伤,占比34.27%。发生心肌损伤患者24 h收缩压(SBP)标准差、昼间SBP标准差、夜间SBP标准差、24 h舒张压(DBP)标准差、昼间DBP标准差以及夜间DBP标准差均高于未发生心肌损伤患者(P<0.05);两组年龄、性别、体重指数、高血压、2型糖尿病、纽约心脏病协会(NYHA)心功能分级、多支血管病变、手术时间、球囊预扩张次数比较,差异无统计学意义(P>0.05)。使用logistic回归分析,结果发现,24 h SBP标准差、昼间SBP标准差、夜间SBP标准差、24 h DBP标准差、昼间DBP标准差以及夜间DBP标准差高表达是不稳定型心绞痛患者介入治疗后心肌损伤的危险因素(OR>1,P<0.05)。结论 血压变异性升高会增加不稳定型心绞痛患者介入治疗后心肌损伤发生率。

Objective To investigate the effect of blood pressure variability on myocardial injury in patients with unstable angina after interventional therapy.Methods This study was a prospective study involving 180 patients with unstable angina admitted to Wugang People’s Hospital from January 2019 to August 2022.Blood pressure variability indicators were measured at the time of admission,and all patients received percutaneous coronary intervention(PCI)treatment.The incidence of myocardial injury in patients 24 hours after surgery was statistically analyzed.Logistic regression analysis was used to examine the impact of blood pressure variability on myocardial injury in patients with unstable angina after interventional therapy.Results Among 180 patients with unstable angina,1 patient failed in revascularization,and 1 patient voluntarily requested to withdraw from the trial.Finally,178 patients completed the study.Among 178 patients with unstable angina,61 cases(34.27%)had myocardial injury.The 24 hours systolic blood pressure(SBP)standard deviation,daytime SBP standard deviation,nighttime SBP standard deviation,24-hour diastolic blood pressure(DBP)standard deviation,daytime DBP standard deviation and nighttime DBP standard deviation in patients with myocardial injury were higher than those in patients without myocardial injury(P<0.05).There was no statistical difference between the two groups in terms of age,gender,body mass index,hypertension,type 2 diabetes,New York Heart Disease Association(NYHA)cardiac function classification,multi-vessel disease,operation time and the number of balloon predilation(P>0.05).Logistic regression analysis showed that the high expression of 24 hours SBP standard deviation,daytime SBP standard deviation,nighttime SBP standard deviation,24 hours DBP standard deviation,daytime DBP standard deviation and nighttime DBP standard deviation were the risk factors of myocardial injury in patients with unstable angina pectoris after interventional therapy(OR>1,P<0.05).Conclusion Elevated blood pressure variability can increase the incidence of myocardial injury in patients with unstable angina after interventional therapy.