不同血压水平与冠脉病变及临床事件的相关性

目的 研究不同血压水平与冠脉病变及临床事件之间的关系。 方法 收集我科行冠脉造影患者276例。根据患者血压状况分为血压正常组（82例），高血压Ⅰ级组（58例），高血压Ⅱ级组（65例），高血压Ⅲ级组（71例）。收集临床资料，冠脉评分采用改良的Gensini评分，分析各组冠状动脉造影结果及心脑血管事件发生率。 结果 各组冠脉病变程度构成比不同，血压正常组重度病变比例最低，高血压Ⅲ级组重度病变比例最高（P<0.05）；多元逐步回归分析显示，年龄、吸烟、糖尿病、高血压均为Gensini评分的危险因素，高密度脂蛋白胆固醇为保护因素；随着血压的升高心脑血管事件发生率明显增高（P<0.05）。 结论 随着血压的升高，冠脉病变程度加重，心脑血管事件发生率增加。

Relationship between hypertension classifications and clinical events in patients with coronary artery lesions

AIM To investigate the relationship between hypertension classifications and clinical events in patients with coronary artery lesions. METHODS Data of 276 patients undergoing coronary angiography were collected. On the basis of blood pressure levels, patients were divided into normal blood pressure group(n=82), essential hypertension(EH) I group(n=58), EH Ⅱ group(n=65) and EH Ⅲ group(n=71). Gensini score was used for coronary assessment. Results of coronary angiography and incidence of clinical events were analyzed in each group and compared between groups. RESULTS The constituent ratio of coronary artery lesion degree was different in each group. The ratio of severe coronary artery lesion in normal blood pressure group was the lowest, whereas that of the EH Ⅲ group was the highest(P<0.05). Multiple regression analysis showed that age, smoking, diabetes and high blood pressure were risk factors of Gensini score, and HDL-C was a protective factor. With the increase in blood pressure, rate of clinical events markedly increased(P<0.05). CONCLUSION Increasing blood pressure worsens coronary artery lesions and increases the clinical event rate.