血压变异性与冠状动脉病变的相关性分析

目的探讨动态血压变异性（ABPV）与冠状动脉病变范围和程度的相关性。方法对本院收治的114例患者行320排动态容积CT冠状动脉造影检查和24h动态血压监测（24hABPM），同时收集患者的年龄、性别血脂、血糖、血压、吸烟等临床指标。根据冠状动脉CT结果分为冠状动脉狭窄组、冠状动脉非狭窄组，分析两组的临床指标和各血压变异性参数的差异，分析血压变异性参数与冠脉病变程度（SSS）的相关性。结果年龄、LDL是显著性影响冠脉病变的危险因素（P〈0．05），而HDL则是显著性影响冠脉病变的保护因素（P〈0．05）。相比冠状动脉非狭窄组，冠状动脉狭窄组的24h收缩压标准差、白昼舒张压标准差和白昼收缩压标准差明显升高（P〈0．05）。年龄和24h舒张压标准差与SSS值之间呈正相关关系（P〈0．05）。冠心病患者随着冠脉病变的狭窄程度和范围增大，血压变异性显著升高。结论血压变异性与冠状动脉狭窄及SSS评分密切相关，是冠状动脉粥样硬化性心脏病的一项重要预测指标。

The Relationship Between Blood Pressure Variabilityand Severity of Coronary Artery Lesions

Objective To investigate the relationship between the blood pressure variability and the severity of coro- nary artery lesions. Methods 114 patients were performed 320-slices spiral CT and 24 hours ambulatory blood pressure monitory （ABPM） from Oct 2008 to Dec 2010. Age, gender, smoking, blood glucose and blood lipids were recorded. All cases were divided into two groups including coronary stenosis group and coronary non-stenosis group according to the results of cor- onary CT. The relations between blood pressure variability and the incidence of coronary artery lesions, the associations be- tween blood pressure variability and the severity of coronary artery lesions （SSS） were analyzed. Results Age and LDL were significant risk factor of coronary atherosclerosis （P 〈 0.05 ）. HDL was significant protect factor of coronary atherosclero- sis（P 〈 0.05）. 24 h systolic blood pressure SD, daytime diastolic blood pressure SD, daytime systolic blood pressure SD had significantly correlation with coronary atherosclerosis （P 〈 0.05）. Age and 24 h diastolic blood pressure SD had positively cor- relation with SSS score（P 〈 0.05）. Conclusion Increased blood pressure variability was associated with the severity and incidence of coronary atherosclerosis. Blood pressure variability is an important predictor of coronary artery disease.