高血压病患者冠状动脉粥样硬化与主动脉脉压的相关性

目的研究冠状动脉粥样硬化与高血压病患者主动脉脉压的关系。方法入选300例初发未经治疗的高血压病患者,根据冠状动脉造影结果将患者分为冠心病组和非冠心病组。在冠状动脉造影前测量主动脉根部的收缩压和舒张压并计算主动脉脉压,收集患者的临床指标和实验室检查资料。结果冠心病组的主动脉收缩压(150.3±26.5 mmHg)和脉压(77.1±22.7 mmHg)明显高于非冠心病组(145.6±23.3 mmHg和70.4±19.3 mmHg,P<0.05),冠心病组每搏输出量与主动脉脉压的比值(1.15±0.44 mL/mmHg)明显低于非冠心病组(1.31±0.50 mL/mmHg,P<0.05)。另外,冠心病组患者的空腹血糖(122.3±24.0 mg/dL比95.6±24.4 mg/dL,P<0.01)和血清肌酐(1.06±0.19 mg/dL比0.99±0.14 mg/dL,P<0.01)比非冠心病组高,而高密度脂蛋白胆固醇(47.7±11.7 mg/dL比54.9±15.6 mg/dL,P<0.01)比非冠心病组低。结论动脉粥样硬化可进一步加重高血压病患者大动脉僵硬度,使主动脉脉压增宽。此外,动脉粥样硬化还导致高血压病患者的肾功能受损,并影响脂质代谢。

Coronary Atherosclerosis and Aortic Pulse Pressure in Hypertensive Patients

Aim To investigate the relationship between coronary atherosclerosis and aortic pulse pressure(APP) in patients with essential hypertension. Methods A total of 300 untreated hypertensive patients were recruited for a first diagnostic coronary angiogram.The following data were collected: invasive intra-aortic systolic and diastolic blood pressure(BP),APP,extent of coronary artery disease,clinical and laboratory characteristics. Results In the whole population,aortic systolic BP and APP were significantly higher in CAD group than no CAD group(150.3±26.5 mm Hg vs 145.6±23.3 mm Hg,p<0.05) and(77.1±22.7 mm Hg vs.70.4±19.3 mm Hg,p<0.05).The ratio of stroke volume(SV) to APP was markedly lower in CAD group(1.15±0.44 mL/mmHg vs 1.31±0.50 mL/mmHg,p<0.05).In addition,CAD group is characterized by higher values of fasting glucose(122.3±24.0 mg/dL vs 95.6±24.4 mg/dL,p<0.01) and serum creatinine(1.06±0.19 mg/dL vs.0.99±0.14 mg/dL,p<0.01),and lower values of HDL cholesterol(47.7±11.7 mg/dL vs.54.9±15.6 mg/dL,p<0.01). Conclusions Atherosclerosis may further aggravate the aortic stiffness in hypertensive patients,therefore result in higher aortic PP.Atherosclerosis can also impair the renal function of hypertensive patients,and bring lipid metabolic disorder.