舒张压对冠状动脉病毒变影响.docVIP

舒张压对冠状动脉病变的影响 韦福起 (盘锦市第一人民医院心血管内科，盘锦，124000) 摘要 目的 观察舒张压增高的高血压病人冠状动脉造影的血管病变特点。方法 按照舒张压水平将108例病人分成3组: A组舒张压≥90mmHg、＜100mmHg；B组舒张压≥100mmHg、＜109mmHg；C组舒张压≥110mmHg。3组收缩压均＜140mmHg，观察3组冠状动脉病变特点。结果 A组分叉病变占7%、多支病变占11%,B组分叉病变占18%、多支病变占29%,C组分叉病变占51%、多支病变占65% ,三组比较有显著差异(P0.01)。结论 舒张压增高易导致冠状动脉分叉处病变;舒张压越高病变越重,多支病变发生率高。 关键词:舒张压;冠状动脉病变;冠状动脉造影 Effect of Diastolic blood pressure on coronary artery lesion Wei Fu-qi (Cardiovascular department of Medicine, The first hospital, Panjin 124000,China.) Abstract　Objective　To observe the angiographic characteristics of coronary artery lesion in patients with hyper diastolic blood pressure .Methods　According to the level of diastolic blood pressure,the 108 patients were devided into three groups: Group A (diastolic blood pressure≥90mmHg,＜100mmHg）, Group B (diastolic blood pressure≥100 mmHg、＜109mmHg＝, Group C (≥110mmHg). All of three groups’ systolic blood pressure were low 140mmHg.Results In Group A ,bifurcation lesion was found in 7% and multivessel coronary disease was found in 11% .In Group B ,bifurcation lesion was found in 18% and multivessel coronary disease was found in 29%.But bifurcation lesion was found in 51% and multivessel coronary disease was found in 65% in Group C. The difference of the multivessel coronary disease rate and bifurcation lesion in group A ,group B and group C was significant (P0.01). Conclusion　 Hyper diastolic blood pressure tends to cause coronary bifurcation lesions. The higher diastolic blood pressure were, the more incidence rate multivessel coronary disease were. Key words Coronary artery disease; diastolic blood pressure; coronary angiography; 　　高血压是最常见的心血管疾病,其主要危害之一是导致广泛的动脉粥样硬化,从而引发各种心血管事件[1] 。高血压病患者发生冠心病较正常血压者高3～4倍。现已明确糖尿病患者的冠状动脉病变主要是弥漫性小血管和多支血管病变为主,而舒张压对冠状动脉病变的影响未见相关报道,本研究将观察舒张压增高患者冠状动脉病变的特点。 1 对象与方法 1.1 对象　选择于2004年8月～2006年8月在我院进行冠状动脉造影的患者共150(男101,女49)例,年龄45～73(56±9)岁。排除急性心肌梗死、风湿性心脏病、先心病及心肌病。高血压病的诊断标准:采用1999年WHO/ISH确定的标准和《中国高血压防治指南》(1999年10月)的规定,按收缩压(SBP)≥140mmHg(1mmHg=0.133kPa)和(或)舒张压≥90mmHg[2