24h动态血压参数与冠脉病变程度的相关性分析

目的]探讨24 h动态血压相关参数与冠状动脉病变严重程度的相关性.方法]选取2018年1月至2018年12月在湘雅医院老年心内科收治的265例行冠状动脉造影检查的患者作为研究对象,所有患者均在冠状动脉造影(CAG)术前进行24 h动态血压监测,记录相关参数,冠脉狭窄病变的严重程度用Gensini积分表示.根据CAG结果分为冠心病组(169例)和非冠心病组(96例),比较两组患者动态血压参数的差异;采用Pearson相关分析所有患者动态血压参数与Gensini积分的相关性;最后将冠心病组患者按照冠脉病变严重程度(Gensini评分)分为轻度病变组、中度病变组及重度病变组,比较不同Gensini积分组动态血压参数的差异.结果]冠心病组男性患者、吸烟患者及合并高血压患者均多于非冠心病组(P<0.05),两组患者在年龄、体重、血糖、血脂、肝肾功能等方面无显著性差异(P>0.05).Pearson相关分析显示各动态血压参数中仅血压变异系数与Gensini积分明显相关(r=0.179,P=0.029).在不同Gensini积分组间,仅血压变异系数存在显著性差异,且随着Gensini积分的增加,血压变异系数越高.结论]血压变异性与冠脉病变的严重程度密切相关,在冠心病患者中血压变异系数可以作为冠脉病变严重程度的预测指标.

Correlation Analysis between 24-hour Ambulatory Blood Pressure Parameters and the Degree of Coronary Artery Disease

Objective]To explore the correlation between 24-hour ambulatory blood pressure and severity of coronary artery disease.Methods]From January 2018 to December 2018,265 patients with coronary angiography in the Department of Geriatric Cardiology of Xiangya Hospital were selected as the research objects.All patients were monitored 24 hours of ambulatory blood pressure before coronary angiography(CAG)operation,and relevant parameters were recorded.The severity of coronary stenosis was expressed by Gensini score.According to the results of CAG,the patients were divided into coronary heart disease group(169 cases)and non coronary heart disease group(96 cases),and the differences of ambulatory blood pressure parameters between the two groups were compared;finally,according to the severity of coronary artery disease(Gensini score),patients in coronary heart disease group were divided into mild disease group,moderate disease group and severe disease group»and the differences of dynamic blood pressure parameters in different Gensini integral groups were compared.Results]There was no significant difference in age,weight,blood sugar,blood lipid,liver and kidney function between the two groups(P>0.05).Pearson correlation analysis showed that only the coefficient of variation of blood pressure was significantly correlated with Gensini score(r=0.179?,P=0.029).In different Gensini integral groups,only the coefficient of variation of blood pressure had significant difference,and with the increase of Gensini integral,the higher the coefficient of variation of blood pressure was.Conclusion]Blood pressure variability is closely related to the severity of coronary lesions.In patients with coronary heart disease the coefficient of blood pressure variability can be used as a predictor of the severity of coronary lesions.