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目的探讨H型高血压患者血压变异性与冠状动脉病变程度的相关性。方法选取2013年1月至2015年7月本院心血管内科确诊的H型高血压患者180例作为研究对象,根据冠脉造影检查是否伴有冠心病分为单纯H型高血压组83例、伴有冠脉病变的97例(冠心病组),对比两组患者的血压变异性指标及与冠脉病变程度的关系。结果冠心病组患者的24 h动态血压监测24 h SBP、d SBP、d DBP、n SBP、n DBP、24h SCV、24 h DCV均高于单纯H型高血压组,差异均具有统计学意义(P<0.05);冠心病组患者的24 h动态血压监测24 h SBP、d SBP、d DBP、n SBP、n DBP、24 h SCV、24 h DCV均随着冠脉病程程度加重而逐渐升高,组间差异均具有统计学意义(P<0.05);采用多元回归逐步进入法进行分析,Gensini评分=2.269+1.770(24 h SCV)+1.224(24 h DCV)。结论 H型高血压患者血压变异性与患者冠脉病变具有密切联系,24 h SCV、24 h DCV是H型高血压冠心病患者冠脉病变的独立危险因素。
Objective To investigate the correlation between the variability of blood pressure and the degree of coronary artery disease in patients with Hypertension. Methods From January 2013 to July 2015, 180 patients with H-type hypertension diagnosed in our hospital were enrolled. According to coronary angiography, coronary heart disease was divided into Hypertension group (n = 83) 97 patients with coronary artery disease (coronary heart disease group), compared the two groups of patients with blood pressure variability and the relationship between the severity of coronary lesions. Results 24-hour ambulatory blood pressure monitoring in 24-h ambulatory blood pressure patients in CHD group was significantly higher than that in Hypertension group at 24 h (P <0.05). The difference was statistically significant (P < P <0.05). 24-hour ambulatory blood pressure monitoring in patients with CHD increased gradually with the severity of coronary artery disease at 24 h after SBP, d SBP, d DBP, n SBP, n DBP, 24 h SCV and 24 h DCV (P <0.05). Gensini score was 2.269 + 1.770 (24 h SCV) + 1.224 (24 h DCV) by using multiple regression step by step analysis. Conclusions The variability of Hypertension patients is closely related to coronary artery disease. 24 h SCV and 24 h DCV are independent risk factors of coronary artery disease in Hypertensive patients with coronary heart disease.