高血压合并冠心病患者血压特点及与心血管事件的相关性研究

目的探讨高血压合并冠心病患者的血压特点及与心血管事件发生的相关性。方法对60例高血压病合并冠心病患者和30例单纯冠心病患者进行24h动态血压监测（ABPM），对所有患者随访6个月～13个月，分析动态血压参数与发生心血管事件的相关性。所有患者都行冠脉造影术，冠脉病变用病变的血管支数及Gensini积分表示。结果高血压合并冠心病患者的心血管事件发生率高于单纯冠心病患者（P〈0．05）。高血压合并冠心病患者中有心血管事件组的年龄、冠脉病变积分、24h动态收缩压（SBP）、日间动态SBP、夜间动态SBP、24h动态脉压（PP）、日间动态PP、夜间动态PP都高于无心血管事件组（P〈0．05）。多因素Logistic回归分析结果显示，年龄、冠脉病变积分、24h动态SBP、夜间动态PP与心血管事件发生关系密切（P〈0．05）。结论年龄、冠脉病变积分、24h动态SBP、夜间动态PP是高血压合并冠心病患者心血管事件发生的危险因素，应对这些因素进行控制以减少高血压合并冠心病患者的心血管事件的发生。

The Characteristics of Blood Pressure and Its Relationship with the Incidence of Cardiovascular Event in Patients with Essential Hypertension Combining Coronary Heart Disease

Objective To investigate the characteristics of blood pressure and its relationship with the incidence of cardiovascular event in patients （pts） with essential hypertension（EH）combining coronary heart disease （CHD）. Methods Blood pressure in 60 pts with EH combining CHD and 30 pts with CHD were measured with ambulatory blood pressure monitoring （ABPM）, pts were followed up for six months to thirteen months. The correlativity between parameters of ambulatory blood pressure and the risk of cardiovascular events were analyzed. All pts underwent coronary angiography. The severity of coronary artery stenosis was evaluated by the number of impaired arteries and Gensini scores. Results The incidence of cardiovascular event was higher in pts with EH combining CHD than that in pts with CHD （P〈0.05）. Age, Gensini scores,24 h systolic blood pressure （SBP）, day SBP, night SBP, 24 h pulse pressure （ PP ） , day PP and night PP were higher in pts with cardiovascular event than that in other pts with EH combining CHD （P〈0.05）. In the Logistic multivariate analysis,age,Gensini score,24 h SBP and night PP were the best predictor for the incidence of cardiovascular event in pts with EH combining CHD. Conclusion Age,Gensini scores, 24 h SBP and night PP were the risk factors for the incidence of cardiovascular event in pts with EH combining CHD. To control these factors might reduce the incidence of cardiovascular event.