高血压患者血压晨峰与冠状动脉病变相关性研究

目的探讨原发性高血压患者血压晨峰（morning blood pressure surge,MBPS）与冠状动脉病变的相关性。方法203例原发性高血压患者行冠状动脉造影术（coronary angiography,CAG）和24h动态血压（ambulatory blood pressure monitoring,ABPM）监测,根据ABPM有无MBPS现象分为晨峰组71例和非晨峰组132例,比较2组冠状动脉病变支数、病变Gensini总积分,分析冠状动脉病变的影响因素。结果晨峰组24h、白昼及夜间平均收缩压、冠状动脉病变发生率、3支病变发生率以及Gensini总积分均高于非晨峰组（P〈0.01）,而单支病变发生率低于非晨峰组（P〈0.01）;冠状动脉病变程度多元线性回归分析结果显示,年龄、24h收缩压及MBPS为冠状动脉病变的独立影响因素。结论 MBPS与冠状动脉病变程度有关,有效控制高血压患者的晨峰血压对减少靶器官损害有重要意义。

Relationship between morning blood pressure surge and coronary artery lesion in hypertensive patients

Objective To discuss the relationship between morning blood pressure surge （MBPS） and coronary artery lesion in patients with essential hypertension. Methods A total of 203 patients with essential hypertension underwent coronary angiography and 24-hour ambulatory blood pressure monitoring （ABPM）, and were divided into MBPS group （n= 71） and non-MBPS group （n= 132） according to ABPM results. The branch numbers of coronary artery lesion and Gensini score were compared between two groups, and influencing factors of coronary artery lesion were analysed. Results The 24-hour, daytime and nighttime mean systolic blood pressure, the incidences of coronary artery lesion and triple-vessel lesion were significantly higher, and the incidence of single-vessel lesion was significantly lower in MBPS group than that in non-MBPS group （P〈0.01）. Stepwise multivariate linear regression revealed the age, 24-hour systolic blood pressure and MBPS were the independent influential factors of coronary artery lesion. Conclusions MBPS is associated with the degree of coronary artery lesion. To control MBPS plays an important role in reducing target organ impairment in hypertensive patients.