2020 年第 1 期 第 15 卷

血压正常人群血压变异性与冠状动脉钙化的相关性分析

Correlation between blood pressure variability and coronary artery calcification in people with normal blood pressure

作者：张宇周玉杰王志坚韩红亚

英文作者：

单位：首都医科大学附属北京安贞医院心内十二病房北京市心肺血管疾病研究所冠心病精准治疗北京市重点实验室首都医科大学冠心病临床诊疗与研究中心100029

英文单位：

关键词：血压变异性；动态血压监测；冠状动脉钙化积分；血压正常人群

英文关键词：

• 摘要：

• 【摘要】目的    探讨血压正常人群血压变异性（BPV）与冠状动脉钙化的相关性。方法    选择2016年1月至2019年6月于首都医科大学附属北京安贞医院住院治疗的血压正常患者152例，均接受螺旋CT心脏冠状动脉成像和24 h动态血压监测，按冠状动脉钙化积分(CACS)分为5组：无钙化组CACS=0分（57例），极少钙化组CACS≤10分（26例），轻度钙化组10分＜CACS≤100分（23例），中度钙化组100分＜CACS≤400分（17例），重度钙化组CACS＞400分（29例）。比较5组患者BPV指标水平，分析CACS与BPV指标的相关性以及CACS的影响因素。结果    重度钙化组24 h收缩压标准差（24 h SSD）、日间收缩压标准差（dSSD）、收缩压加权标准差（SwSD）、24 h收缩压变异系数（24 h SCV）、日间收缩压变异系数（dSCV）水平显著高于其他4组（均P＜0.05）。CACS与24 h SSD、dSSD、24 h SCV、dSCV、SwSD均呈正相关（r=0.289、0.284、0.218、0.226、0.252，P＜0.001、＜0.001、=0.007、=0.005、=0.002），多因素Logistic回归分析结果表明，吸烟、24 h SSD、dSSD、24 h SCV、dSCV、SwSD均为CACS的影响因素（比值比=1.426、6.210、1.911、2.071、1.260、3.728，均P＜0.05）。结论    血压正常人群中收缩压变异性尤其是日间收缩压变异性与冠状动脉钙化具有相关性；血压正常人群收缩压变异性的异常程度越高，冠状动脉钙化程度越重。

• 【Abstract】Objective    To investigate the correlation between blood pressure variability(BPV) and coronary artery calcification in people with normal blood pressure. Methods    From January 2016 to June 2019, 152 patients with normal blood pressure were enrolled in Beijing Anzhen Hospital, Capital Medical University. All patients had spiral CT coronary artery imaging and 24 h ambulatory blood pressure monitoring. According to the coronary artery calcification score(CACS), the patients were divided into 5 groups: non-calcification group, CACS＝0, 57 cases; minimal calcification group, CACS≤10, 26 cases; mild calcification group, 10＜CACS≤100, 23 cases; moderate calcification group, 100＜CACS≤400, 17 cases; severe calcification group, CACS＞400, 29 cases. Correlation between CACS and BPV and the influencing factors of CACS were analyzed. Results    Levels of 24 h standard deviation of systolic pressure（24 h SSD）, daytime standard deviation of systolic pressure(dSSD), weighted standard deviation of systolic pressure(SwSD), 24 h variation coefficient of systolic pressure(24 h SCV) and daytime variation coefficient of systolic pressure(dSCV) in the severe calcification group were significantly higher than those in the other 4 groups（all P＜0.05）. CACS was positively correlated with 24 h SSD, dSSD, 24 h SCV, dSCV and SwSD（r=0.289, 0.284, 0.218, 0.226, 0.252; P＜0.001, ＜0.001, 0.007, 0.005, 0.002）. Multiple logistic regression analysis showed that smoking, 24 h SSD, dSSD, 24 h SCV, dSCV and SwSD were influencing factors of CACS（odds ratio=1.426, 6.210, 1.911, 2.071, 1.260, 3.728; all P＜0.05）. Conclusion    Systolic blood pressure variability, especially daytime variability, is correlated with coronary artery calcification in normal blood pressure population; the severity of coronary artery calcification increases with abnormal systolic blood pressure variability.