摘要
目的探讨老年高血压患者经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)术后血压昼夜节律与冠脉病变的相关性。方法选择已在福建省立医院行PCI术后1年,于2017年1月至2020年l2月期间再次入院复查冠脉造影的老年高血压患者178例;住院期间完善24h动态血压监测(ambulatory blood pressure monitoring,ABPM),根据ABPM的监测结果分为杓型组(n=62)及非杓型组(n=116)。以Gensini积分法对冠状动脉狭窄程度进行量化得到冠状动脉病变积分(coronary artery score,CAS),并收集各项临床资料进行对比分析。结果非杓型组CAS显著高于杓型组[(30.39±7.64)分比(36.47±10.52)分,t=﹣3.277,P<0.05]。各变量间的Spearman相关分析显示,CAS与平均舒张压、夜间平均收缩压、夜间平均舒张压、夜间血压下降幅度呈负相关(r=﹣0.218,r=﹣0.319,r=﹣0.352,r=﹣0.213,均P<0.05)。结论血压昼夜节律异常与PCI术后1年老年高血压患者的冠状动脉病变进展有关,非杓型血压节律可能促进冠脉病变加重。
Objective To investigate the correlation between circadian rhythm of blood pressure and coronary artery disease in elderly hypertensive patients after percutaneous coronary intervention(PCI).Methods One year after coronary stent implantation,178 elderly hypertensive patients were admitted to hospital again for coronary angiography from January 2017 to December 2020.24-hour ambulatory blood pressure monitoring(ABPM)was improved during hospitalization,and the patients were divided into dipper group(n=62)and non-dipper group(n=116)according to ABPM monitoring results.The coronary artery stenosis degree was quantified by Gensini integral method,the coronary artery lesion score(CAS)was obtained,and the clinical data was collected and analyzed.Results CAS in non-dipper group was significantly higher than that in dipper group(30.39±7.64 vs 36.47±10.52,P<0.05).Spearman correlation analysis showed that CAS was negatively correlated with mean diastolic blood pressure,mean systolic blood pressure at night and mean diastolic blood pressure at night(r=﹣0.218,r=﹣0.319,r=﹣0.352,r=﹣0.213,all P<0.05).Conclusion Abnormal circadian rhythm of blood pressure is related to the progression of coronary artery disease in elderly hypertensive patients one year after PCI.Nondipper blood pressure rhythm may promote the aggravation of coronary artery disease.
作者
张都生
吴志勇
林锋
陈威
郭延松
Zhang Dusheng;Wu Zhiyong;Lin Feng;Chen Wei;Guo Yansong(Shengli Clinical Medical College of Fujian Medical University,Fuzhou 350001,China;Department of Cardiology,Fujian Provincial Hospital,Fuzhou 350001,China)
出处
《创伤与急诊电子杂志》
2021年第3期176-180,共5页
Journal of Trauma and Emergency(Electronic Version)
关键词
血压昼夜节律
杓型高血压
非杓型高血压
冠状动脉性心脏病
Blood pressure circadian rhythm
Dipper hypertension
Non-dipper hypertension
Coronary heart disease
