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目的探讨冠心病合并高血压患者的脉压与冠状动脉病变程度及心功能的相关性。方法选择经冠脉造影证实的冠心病且合并高血压患者248例,男161例,女87例,平均年龄65.7岁,急性心肌梗死合并有高血压122例,心绞痛合并高血压126例,作为二个大组,每组又分为两个亚组,分为低脉压组(PP<60mmHg)和高脉压组(PP≥60mmHg),每一组60例左右。在每一个大组内和大组之间,对冠状动脉病变程度(冠脉狭窄支数、狭窄程度)、血压参数(SBP、DBP、MBP、PP)、心功能参数(EF、E/A值)、舒张末期室间隔厚度(ⅣSD)、舒张末期后壁厚度(LVPWD)、左室重量指数(LVMI)进行比较。结果①PP≥60mmHg组病人冠状动脉3支血管病变的患病率显著增高(P<0.05)。②随着PP增大,左心室收缩及舒张功能均明显的降低,PP与患者左心功能不全发生存在明显的相关性。结论PP高的冠心病病人较PP低的冠心病病人冠状动脉病变较为严重,PP与有冠状动脉病变程度有相关性。PP是左心功能不全发生的一个重要的相关因素,且随着PP增大,左心室收缩及舒张功能均明显的降低。
Objective To investigate the correlation between pulse pressure and severity of coronary artery disease and cardiac function in patients with coronary heart disease complicated with hypertension. Methods Select coronary artery disease confirmed by coronary angiography in 248 cases of patients with hypertension, 161 males and 87 females, mean age 65.7 years, acute myocardial infarction with hypertension in 122 cases, angina pectoris with hypertension in 126 cases, as two A large group, each group is divided into two subgroups, divided into low pulse pressure group (PP <60mmHg) and high pulse pressure group (PP≥60mmHg), each group of 60 cases. The severity of coronary artery disease (coronary stenosis, stenosis), blood pressure (SBP, DBP, MBP, PP), cardiac function parameters (EF, E / A value ), End diastolic interventricular septum thickness (IVSD), end-diastolic wall thickness (LVPWD) and left ventricular mass index (LVMI). Results ① The prevalence of 3 vessel lesions of coronary arteries in PP≥60mmHg group was significantly higher (P <0.05). ② With the increase of PP, left ventricular systolic and diastolic function were significantly reduced, PP and left ventricular dysfunction in patients there is a clear correlation. Conclusions The patients with PP high coronary heart disease have more severe coronary artery disease than those with PP low coronary artery disease. PP has a correlation with the severity of coronary artery disease. PP is an important related factor of left ventricular dysfunction, and with the increase of PP, left ventricular systolic and diastolic function were significantly reduced.