[1]张克梵,王琼英,白 锋.高血压患者冠状动脉慢血流与夜间血压下降率相关性研究[J].陕西医学杂志,2024,(8):1060-1064,1068.[doi:DOI:10.3969/j.issn.1000-7377.2024.08.011]
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高血压患者冠状动脉慢血流与夜间血压下降率相关性研究
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
期数:
2024年8期
页码:
1060-1064,1068
栏目:
临床研究
出版日期:
2024-08-05

文章信息/Info

作者:
张克梵王琼英白 锋
(兰州大学第二医院心血管内科,甘肃 兰州 730030)
关键词:
高血压 冠状动脉慢血流 夜间血压下降率 相关性 冠状动脉造影 动态血压
分类号:
R 544.1
DOI:
DOI:10.3969/j.issn.1000-7377.2024.08.011
文献标志码:
A
摘要:
目的:探讨高血压患者冠状动脉慢血流与夜间血压下降率的相关性。方法:纳入冠状动脉造影术提示冠状动脉慢血流的患者201例为研究对象,根据是否合并高血压将患者分为冠脉慢血流合并高血压组(108例)和冠脉慢血流组(93例)。将同期住院患者中冠脉造影提示狭窄程度≤40%的单纯原发性高血压患者74例纳入高血压组,将无心血管疾病的患者29例纳入对照组。收集所有患者一般临床资料,进行实验室指标检查和冠状动脉造影,采集动态血压数据。比较四组患者24 h、白天、夜间平均血压及夜间血压下降率。使用线性相关性分析和线性回归分析探究冠状动脉慢血流与夜间血压下降率的相关性。结果:与对照组比较,冠脉慢血流合并高血压组患者男性比例较高、年龄较大,且合并2型糖尿病、脑梗死的比例较高(均P<0.05)。与高血压组比较,冠脉慢血流合并高血压组患者男性比例较高、年龄较大(均P<0.05)。冠脉慢血流组患者男性比例及年龄高于对照组(均P<0.05)。冠脉慢血流合并高血压组及冠脉慢血流组患者高密度脂蛋白胆固醇(HDL-C)水平较低(均P<0.05)。冠脉慢血流合并高血压组和高血压组患者白天、夜间、24 h的平均收缩压(SBP)、舒张压(DBP)高于冠脉慢血流组及对照组(均P<0.05)。冠脉慢血流合并高血压组患者夜间血压下降率低于其余三组(均P<0.05)。冠脉慢血流合并高血压组及冠脉慢血流组患者动脉硬化指数高于高血压组及对照组(均P<0.05)。线性相关性分析结果显示,夜间血压下降率与左前降支(LAD)校正后的心肌梗死溶栓治疗(TIMI)帧数(CTFC)、左回旋支(LCX)TIMI帧数(TFC)、右冠状动脉(RCA)TFC、平均TFC呈负相关,动脉硬化指数与LAD CTFC、LCX TFC、RCA TFC、平均TFC呈正相关(均P<0.05)。夜间血压水平与LAD CTFC、LCX TFC、RCA TFC、平均TFC无相关性(均P>0.05)。在校正了性别、年龄、体重指数、吸烟、糖尿病、脑梗死等混杂因素后,多元线性回归分析显示夜间血压下降率与冠状动脉TFC依然具有相关性(均P<0.05)。结论:在高血压患者中,冠状动脉血流速度与夜间血压下降率独立相关,与夜间血压水平无相关性。无论是收缩压还是舒张压,当夜间血压下降率减低时,冠状动脉TFC增加,血流速度减慢。

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备注/Memo

备注/Memo:
基金项目:甘肃省自然科学基金资助项目(21JR1RA168)
更新日期/Last Update: 2024-08-08