高血压患者动态脉压及脉压指数与冠心病的关系

发布时间：2018-06-04 06:19

  本文选题：高血压 + 冠状动脉疾病　； 参考：《中国循环杂志》2017年05期

【摘要】：目的:探讨高血压患者24 h动态脉压(24hPP)、24 h动态脉压指数(24hPPI)和夜间动态脉压指数(NPPI)与冠心病的相关性。方法:共入选305例于2016-05至2016-07在阜外医院进行动态血压监测(ABPM)的受试者,根据ABPM数据计算受试者的24hPP、24hPPI和NPPI,并分析这些指标与冠心病的相关性。24hPP为24 h平均收缩压(24hSBP)与24 h平均舒张压(24hDBP)之差,24hPPI为24hPP与24hSBP的比值,NPPI为夜间(22:00~06:00)平均PP与平均SBP的比值。结果:305例受试者中,222例(72.8%)为高血压患者。高血压患者的24hPP、24hPPI、NPPI均高于血压正常者[24hPP:(49.0±11.6)mmHg(1 mmHg=0.133 kPa)vs.(42.2±7.4)mmHg,P0.001;24hPPI:0.39±0.06 vs.0.37±0.05,P=0.004;NPPI:0.40±0.07 vs.0.38±0.05,P=0.009]。222例高血压患者中,116例(52.3%)冠心病患者的24hPP、24hPPI和NPPI均高于106例(47.7%)无冠心病者[24hPP:(50.9±12.2)mmHg vs.(47.0±10.6)mmHg,P=0.013;24hPPI:0.41±0.06 vs.0.38±0.06,P0.001;NPPI:0.42±0.07 vs.0.38±0.06,P0.001];而在83例(27.2%)血压正常的受试者中,冠心病患者和无冠心病者上述指标之间的差异均无统计学意义。Logistic回归模型分析显示,调整年龄、性别、体重指数、降压药服用情况等因素后,高血压患者的24hPPI和NPPI与冠心病相关[24hPPI:比值比(OR)=1.95,95%可信区间(CI):1.11~3.44,P=0.020;NPPI:OR=2.21,95%CI:1.28~3.82,P0.001]。受试者工作特征(ROC)曲线分析结果显示,高血压患者的24hPPI和NPPI对冠心病的筛查和预测价值均优于24hPP。结论:高血压患者的24hPPI和NPPI与冠心病密切相关,有助于高血压患者冠心病的筛查和预测,且效果优于24hPP。
[Abstract]:Objective: to investigate the correlation between 24 h dynamic pulse pressure (24 h) and 24 h NPPI (dynamic pulse pressure index (NPPI) and coronary heart disease (CHD) in patients with hypertension. Methods: a total of 305 subjects were selected to perform ambulatory blood pressure monitoring (ABPM) in Fuwei Hospital from May 2005 to July 2016-07. The correlation between these indexes and coronary heart disease was analyzed according to the ABPM data. The difference between 24hPP (24 h SBP) and 24 h mean diastolic blood pressure (24hDBP) was the ratio of 24hPP to 24hSBP. The ratio of NPPI to 24hSBP was 22: 0006: 00 at night. Results among 305 subjects, 222 cases were diagnosed as hypertensive patients. 楂樿��鍘嬫偅鑰呯殑24hPP,24hPPI,NPPI鍧囬珮浜庤��鍘嬫�ｅ父瑁�

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