原发性高血压合并冠心病患者的血压水平特点研究

目的：分析原发性高血压合并冠心病患者的24 h 时动态血压及动态心电图,探讨高血压合并冠心病患者的血压水平特点及其与心肌缺血负荷的相关性。方法选经冠状动脉造影检查的原发性高血压患者139例为研究对象,根据冠状动脉检查结果分为原发性高血压合并冠心病组(观察组)74例,单纯原发性高血压病组(对照组)65例,均采用24 h 动态血压和动态心电图监测,对所得相关数据进行分析。结果(1)观察组夜间收缩压平均值高于对照组,各时段舒张压平均值低于对照组,24 h 和白昼平均动脉压平均值低于对照组,差异有统计学意义(P <0.05)。(2)24 h 心肌缺血总负荷(TIB)与相应的收缩压、舒张压、脉压水平存在显著的相关性(分别为 r=0.409,P =0.000；r=-0.306,P =0.008；r=0.615,P =0.000)；白昼 TIB 与相应的收缩压、脉压水平之间存在显著正相关(r=0.417,P =0.000；r=0.402,P =0.001)；夜间 TIB 与相应的收缩压、脉压水平之间存在显著正相关(r=0.511,P =0.000；r=0.596,P =0.000)。结论原发性高血压合并冠心病患者的血压有脉压差大,夜间收缩压的水平较高,舒张压及24 h、白昼平均动脉压水平较低的特点,并且与 TIB 存在显著相关性。

Study on the characteristics of blood pressure levels in patients with primary hypertension and coronary heart disease

Objective To study and analyze the 24 h ambulatory blood pressure and ambulatory electrocardiography in pa-tients with primary hypertension and coronary heart disease,the characteristics of blood pressure level of patients with hypertension and coronary heart disease and its correlation with myocardial ischemic burden in these patients were explored.Methods Selected by coronary angiography examination,139 cases of patients with high blood pressure,according to the results of coronary artery ex-amination were divided into high blood pressure with coronary heart disease group(observation group)74 cases and simple hyper-tension group(control group)65 cases.Two groups all were used 24 hours ambulatory blood pressure monitoring and ambulatory ECG monitoring.The relevant data were analyzed.Results (1)Observation group nocturnal systolic blood pressure was higher than the average in control group,the time of diastolic pressure was lower than the control group,24 hours and the average artery pres-sure was lower than the control group,the difference was statistically significant(P <0.05).(2)Total ischemia burden(TIB)and the corresponding systolic pressure,diastolic pressure,pulse pressure levels existed significant correlation(respectively r =0.409, P =0.000;r=-0.306,P =0.008;r =0.61 5,P =0.000);there was a significant positive correlation between day TIB and corre-sponding systolic pressure,pulse pressure level(r=0.41 7,P =0.000;r=0.402,P =0.001);there was a significant positive correla-tion between TIB and the corresponding nighttime systolic blood pressure,pulse pressure level(r=0.5 1 1,P =0.000;r=0.596,P =0.000).Conclusion The levels of nocturnal systolic pressure,diastolic pressure and the time of 24 hours are higher,and the average artery pressure levels are relatively low.There is a significant correlation with the myocardial ischemic burden.