2017 年第 10 期 第 12 卷

_冠状动脉粥样硬化性心脏病患者动态脉压水平与冠状动脉病变严重程度的关系_

Relevance between ambulatory pulse pressure and severity of coronary artery lesion in patients with coronary atherosclerotic heart disease

作者：贺鹏辉王西辉吴娟

英文作者：He Penghui Wang Xihui Wu Juan

单位：710038 西安医学院第二附属医院心血管内科陕西省心血管内科疾病临床医学研究分中心

英文单位：Department of Cardiovascular Medicine the Second Affiliated Hospital of Xi′an Medical University Shaanxi Provincial Sub-center for Clinical Medical Research of Cardiovascular Diseases Xi′an 710038 China

关键词：冠状动脉疾病；动态脉压；冠状动脉病变

英文关键词：Coronaryheartdisease;Ambulatorypulsepressure;Coronaryarterylesion

• 摘要：

• 目的 探讨冠状动脉粥样硬化性心脏病（冠心病）患者动态脉压水平与冠状动脉病变严重程度的关系。方法 选取2014年2月至2016年2月西安医学院第二附属医院经冠状动脉造影检查确诊为冠心病的患者75例作为观察组，另选同期健康体检者50例作为对照组。记录2组研究对象的白天、夜间和24 h平均血压和脉压水平。使用冠状动脉Gensini评分评估观察组患者冠状动脉病变狭窄程度。分析平均血压和脉压水平与冠状动脉病变程度的关系。结果 观察组白天、夜间及24 h平均血压和脉压水平明显高于对照组［平均血压：（104.2±3.5）mmHg（1 mmHg=0.133 kPa）比（95.3±2.2）mmHg、（103.6±3.1）mmHg比（94.9±2.8）mmHg、（103.8±3.4）mmHg比（95.0±2.6）mmHg，脉压：（45.4±2.2）mmHg比（40.3±2.1）mmHg、（43.7±2.4）mmHg比（39.4±2.4）mmHg、（44.3±2.6）mmHg比（39.7±2.5）mmHg］（均P＜0.05）。平均血压和脉压水平在不同病变支数、不同病变程度冠心病患者间差异均有统计学意义（均P＜0.05)。观察组Gensini评分与平均血压和脉压水平均呈正相关（r＝0.352，P＜0.05；r＝0.583，P＜0.05）。结论 脉压水平可作为判断和预测冠心病患者冠状动脉病变程度的有效指标。

• Objective To analyze the relevance between dynamic pulse pressure（PP） and severity of coronary artery lesion in patients with coronary atherosclerotic heart disease（CHD）. Methods From February 2014 to February 2016, 75 patients with CHD diagnosed by coronary angiography in the Second Affiliated Hospital of Xi′an Medical University were enrolled as observation group; 50 healthy people were enrolled as observation group. Daytime, nighttime and 24 h mean blood pressure（MAP） and PP were recorded. The severity of coronary artery disease was assessed by the Gensini score. The correlation among MAP, PP and Gensini score was analyzed. Results Daytime, nighttime and 24 h MBP and PP in observation group were significantly higher than those in control group［MBP： （104.2±3.5）mmHg vs （95.3±2.2）mmHg, （103.6±3.1）mmHg vs （94.9±2.8）mmHg, （103.8±3.4）mmHg vs （95.0±2.6）mmHg; PP： （45.4±2.2）mmHg vs （40.3±2.1）mmHg, （43.7±2.4）mmHg vs （39.4±2.4）mmHg, （44.3±2.6）mmHg vs （39.7±2.5）mmHg］（P＜0.05）. There were also significant differences of MBP and PP among CHD patients with different numbers of coronary lesions and different degrees of coronary stenosis（P＜0.05）. Linear correlation analysis showed positive correlations of Gensini score with MAP and PP（r＝0.352, P＜0.05； r＝0.583, P＜0.05）. Conclusion PP is an effective indicator for predicting the severity of coronary artery lesion in patients with CHD.