主动脉脉压及脉压指数对女性冠心病的预测价值

目的 通过分析直接法测得的主动脉脉压（PP）及脉压指数（PPI）与女性冠心病发病及冠状动脉病变严重程度的相关性,探讨主动脉PP及PPI在预测女性冠心病中的价值.方法 对疑诊冠心病并行诊断性冠状动脉造影检查的717例女性患者进行回顾性分析.以冠状动脉造影阳性（主要血管直径狭窄≥50％）作为诊断冠心病的标准,以冠状动脉病变受累的支数评估冠脉病变程度.采用单因素方差分析及多因素回归分析观察主动脉PP及PPI与女性冠心病发病及冠状动脉病变严重程度的关系.结果 冠心病组患者主动脉PP[（62.55±22.65）mm Hg比（54.96±21.51）mm Hg,P＜0.001]和PPI[（0.44±0.10）比（0.40±0.11）,P＜0.001]明显高于非冠心病组患者.随着冠状动脉病变支数增加,PP及PPI逐渐增加.单因素相关性分析结果显示,主动脉PP及PPI与冠心病发病（r=0.166,0.190,P＜0.001）及冠状动脉受累支数（r=0.177,0.196,P＜0.001）呈正相关.多因素logistic回归分析结果显示,主动脉PPI对冠心病发病有独立预测价值（OR=8.065,95％ CI 1.628～39.951,P=0.003）.结论 主动脉PP及PPI水平与女性冠心病发病及冠状动脉病变严重程度相关.PPI是女性患者冠脉造影确诊冠心病的独立预测指标.

The value of aorta pulse pressure/pulse pressure index in predicting the coronary heart disease in female patients

Objective The present study was undertaken to investigate the significance of aorta pulse pressure（PP） and pulse pressure index（PPI） in predicting the incidence of coronary heart disease（CHD） and the severity of coronary artery lesion in female patients. Methods 717 female patients who had undergone coronary angiograthy were divided into CHD group[n=426, mean age （68.85±9.11）years old ] and non CHD group[n=291, mean age （61.9±9.6）years old] according to the results of coronary angiography. The severity of coronary artery atherosclerosis was assessed by the number of stenosis coronary artery. Aorta blood pressure was measured during coronary angiography. Results Aortic PP and PPI in the CHD group were significantly higher than those in the non CHD group[PP （62.55 ± 22.65）rmn Fig vs （54.96±21.51）mm Hg,P〈O.001,PPI （0.44±0.10） vs （0.40±0.11）, P〈0.001 ]. Linear correlation analysis indicated that PP and PPI were significantly positively associated with the oc- currence of CHD（r=0.166, 0.190, P〈0.001 ）. Furthermore, the severity of coronary artery atherosclerosis was as- sociated with increased PP and PPI（r=0.177,0.196, P〈0.001）. Logistic multivariate analysis showed that PPI was a independent predictor of CHD （0R=8.065, 95% CI 1.628-39.951, P=0.O03）. Conclusion The levels of aorta PP and PPI were significantly positively associated with the occurrence of CHD and the severity of coronary artery lesion in female patients. PPI is the most prominent predictor in diaiznosis of CHD in woman,