血压与冠状动脉造影病变的关系

目的研究血压与冠状动脉病变的关系。方法选择可疑冠心病患者540例,根据冠状动脉有无病变分为病变组和无病变组;根据冠状动脉病变的范围分为单支血管病变组、双支血管病变组和三支血管病变组。所有患者入院后测量血压,并对每一个患者进行高血压、吸烟和糖尿病病史的调查,测定血脂水平。采用Judkins法进行冠状动脉造影。结果病变组高血压病程(5.85±8.87年)、收缩压(133±29 mm Hg)、舒张压(83±13 mm Hg)、脉压(51±17 mm Hg)及平均压(100±14 mm Hg)均明显高于无病变组(分别为1.78±4.27年、125±21 mm Hg、80±13mm Hg4、8±15 mm Hg和97±15 mm Hg)(P<0.05)。三支血管病变组高血压病程、收缩压和脉压水平(分别为7.42±10.10年、137±21 mm Hg和54±17 mm Hg)均高于单支血管病变组(分别为4.51±7.21年、132±19 mm Hg和49±16 mm Hg)和双支血管病变组(分别为5.76±8.79年1、34±23 mm Hg和52±17 mm Hg)(P<0.05)。随着高血压病程增加、收缩压、脉压及平均压水平的增高,冠状动脉病变狭窄程度逐渐增大;经多因素回归分析高血压病程(OR值=0.139,P<0.05)、年龄(OR值=1.045,P<0.05)等因素是冠心病发生独立的危险因素。结论随着年龄增大和高血压病程增加,患冠心病的机会增加,并且收缩压和脉压的升高对冠状动脉的危害性较大。

Relationship Between Blood Pressure and Coronary Artery Lesion

Aim To evaluate the relationship between blood pressure and the range and severity of coronary artery stenosis. Methods 540 inpatients who had been diagnosed with suspicious coronary heart disease(CHD) were carried through coronary angiography.Blood pressure and blood lipoprotein of all patients were measured.Their history of high blood pressure,smoking and diabetes was investigated.All patients were carried with angiography by Judkins way.Based on coronary artery lesion 540 inpatients were separated into two groups: lesion group and no lesion group;based on coronary artery lesion range 540 inpatients were separated into three groups: single vessel disease group,double vessel disease group and triple vessel group. Results Coronary angiography shows that patients in lesion group have more hypertension history(5.85 ±8.87 years),higher level of systolic blood pressure(133±29 mm Hg),diastolic blood pressure(83±13 mm Hg),pulse pressure(51±17 mm Hg) and mean blood pressure(100±14 mm Hg) than that in no lesion groups(1.78±4.27 years,125±21 mm Hg,80±13 mm Hg,48±15 mm Hg and 97±15 mm Hg). There were more hypertension history,higher level of systolic pressure and pulse pressure in single vessel disease group and triple vessel group(7.42±10.10 years,137±21 mm Hg and 54±17 mm Hg) than that in single vessel disease group(4.51±7.21 years,132±19 mm Hg and 49±16 mm Hg),and double vessel disease group(5.76±8.79 years,134±23 mm Hg and 52±17 mm Hg).Difference among three groups had noticeable significance(p<0.05).Severity of coronary artery stenosis was developed with more hypertension history,higher level of systolic blood pressure,pulse pressure and mean blood pressure.Hypertension(OR=0.139,p<0.05),and ages(OR=1.045,p<0.05) were independent risk factors for happening of coronary artery disease by multiple factor regression analysis. Conclusions Opportunity of coronary artery disease was increased with ages and hypertension history.Moreover,higher level of systolic blood pressure and pulse pressure were more harmful than others.