高血压病患者冠状动脉病变与脉压和脉压指数的相关性分析

目的　探讨高血压病患者冠状动脉病变与脉压和脉压指数的相关性。方法　对拟诊冠心病(CHD)的 4 32例高血压病患者 (观察组 )及 2 92例血压正常者 (对照组 )以标准Judkins法行冠状动脉造影术 ,计算机定量分析系统 (QCA)分析冠状动脉狭窄程度并计算其冠状动脉病变积分 (CAS)。标准台式水银血压计测定外周肱动脉收缩压 (SBP)和舒张压 (DBP)并计算脉压 (PP)及脉压指数 (PPI)。结果　高血压病患者的CAS、PP、PPI及升主动脉内径 (Ao)等指标显著高于非高血压病患者 ;两组患者的CAS均与性别、SBP、PP、PPI及Ao等因素相关 ,而高血压病患者的HDL_C、非高血压病患者的年龄和体重指数也分别与其CAS相关 ;多因素Lo gistic逐步回归分析发现高血压病患者CHD的发生与其PPI( β =0 0 31,P =0 0 0 1,EXP(β) =1 0 32 )和Ao( β =0 183,P =0 0 0 0 ,EXP(β) =1 2 0 1)的相关性最为显著 ,而非高血压病患者CHD的发生只与其PPI( β=0 10 3,P =0 0 0 0 ,EXP(β) =1 10 9)的相关性最为显著。结论　PPI和Ao是高血压病患者CHD发生发展的一个重要的、独立的预测指标 ,同时PPI对于血压正常者是否发生CHD也有良好的预测价值

A Study of the Relationship between Coronary Artery Disease and Pulse Pressure and Pulse Pressure Index in Patients with Essential Hypertension

ObjectiveTo evalute the relationship b et ween coronary artery disease and pulse pressure and pulse pressure index in pati ents with essential hypertension.Methods724 cases who were suspected to have coronary heart disease (CHD) were divided into two groups :observe group (432 cases with essential hypertension) and control group (292 ca ses with normal blood pressure).Coronary angiography was performed in all cases. Then the severity of coronar artery lesions was analysed by quantitive computer system (QCA) to acquire coronary artery score (CAS).Brachial systolic blood pres sure (SBP),diastolic blood pressure (DBP),pulse pressure (PP) and pulse pressure index (PPI) were measured by sphygmomanometer.Results CAS,PP,PPI and Ao of observe group were significantly higher than those of contr ol group.The two groups CAS significantly related to sex,SBP,PP,PPI and Ao.HDL C of observe group correlated with CAS significantly,and so did age and body m ass index of the control group.In a logistic multivariate analysis,the occurrenc e of CHD in observe group has significantly correlation with PPI (β=0 031,P =0 001,EXP (β) =1 032) and Ao (β=0 183,P=0 000,EXP (β) =1 201) mostly,while the occurrence of CHD in the control group has only sig nificantly correlation with PPI (β=0 103,P=0 000,EXP (β) =1 109) m ostly.Conclusions PPI and Ao are independent and import ant predictors for developing CHD in essential hypertension patients.PPI is an evaluable predictor for developing CHD even in people with normal blood pressure .