高血压病程及血脂对冠状动脉造影病变程度的影响

目的探讨高血压病程及血脂与冠状动脉造影病变程度的关系。方法502例住院患者作为研究对象,所有病例均经选择性冠状动脉造影分组,按照有无冠状动脉狭窄及其程度分为：无病变及狭窄性病变、斑块浸润性病变、单支病变、双支病变、三支病变及弥漫病变五组;所有患者入院后测量血压,并对每一个患者进行高血压和糖尿病病史的调查,测定血脂水平;经桡动脉或股动脉途径进行选择性冠状动脉造影。结果随着冠状动脉造影病变程度分级的加重,高血压组患者数逐渐增加,卡方检验示P＆lt;0.01,有显著性统计学意义。在冠状动脉造影病变程度的分级各组中,随着病变程度的加重高血压患者的比例逐渐增多,说明高血压病是冠状动脉病变严重程度的相关因素。高血压病患者的发病病程,随着冠状动脉造影病变程度分级的加重,高血压组患者病程数值逐渐增加,One-WayANOVA过程检验示P＆lt;0.01,有显著性统计学意义。随着冠状动脉狭窄程度的加重,血浆总胆固醇、低密度脂蛋白胆固醇、载脂蛋白B、三酰甘油、脂蛋白（a）水平呈逐渐增高趋势;载脂蛋白A1（ApoAl）、高密度脂蛋白胆固醇有下降的趋势;年龄愈大,冠脉病变的严重程度愈重;体质量、三酰甘油水平在冠心病各组中无明显差别。结论高血压病是冠状动脉病变严重程度的相关因素，高血压病患者病程愈长冠状动脉造影病变程度及范围愈重。

Effect of hypertension history on coronary artery stegnotic lesion degree

Objective To evaluate the relationship between hypertension, its history and stegnotic lesion degree of coronary artery. Methods 502 cases of patients all assessed with coronary angiography were divided into five groups according to the stegnotic lesion degree of coronary artery. There are none stenosis, lipid plaque, single branch, double branch, three branch and diffuse stenosis. Analysis of blood lipid, apolipoprotein and LP（a）were examined in early morning at empty stomach after 12 hours of next admission day. Other risk factors were also recorded, such as history of hypertension, diabetic mellitus, etc. Results Along with the stegnotic lesion degree of coronary artery heavier, the number of hypertension patients more, the difference was significant（ P 〈 0. 01 ） ; the course of hypertension disease was longer with the heavier of lesion degree of coronary artery, the difference was also significant（ P 〈 0. 01 ）in One-Way ANOVA course; the levels of High density lip- oprotein （HDL） and Apolipoprotein A1 （ ApoA1 ） have a lower trend; the levels of Total Cholesteral （ TC ）, Low density lipoprotein （LDL）, Apolipoprotein B （ APOB ）, Lipoprotein （a） LP （a） ], Body weight and Triglyceride （TG） have no difference in the group of CHD. Age is also a significantly predicted factor in the coronary stenosis：the older,the heavier. LP（a） and age are especially important severity factors in juge of stegnotic lesion degree of coronary artery. Conclusion Hypertension was close relative factor in the stegnotic lesion degree of coronary artery, the longer of the course of hypertension, the heavier of the stegnotic lesion degree of coronary artery,