摘要
目的:探讨动态脉压(Ambulatory Pulse Pressure,PP)水平对老年高血压患者冠脉介入(Percutaneous Coronary Intervention,PCI)术患者的危险分层和预后评价。方法:入选老年高血压患者,同时符合冠心病诊断标准,并且接受PCI治疗的138例患者,并进行动态血压监测,根据PP>60 mm Hg和≤60 mm Hg分为两组,分别为52例和86例,观察患者临床特征和冠状动脉病变的严重程度,并随访平均(18.6±4.3)个月主要心血管事件。结果:与PP≤60 mm Hg组比较,PP>60 mm Hg组多见男性和糖尿病史多,C型病变和三支病变常见。两组间比较,围手术期并发症发生率、住院期非致死性心肌梗死发生率和远期心源性死亡发生率在PP>60 mm Hg组显著增加,分别为16.8%vs8.8%,5.2%vs2.3%和1.3%vs0.8%,均为P<0.05。多因素logistic分析PCI术后住院期间主要不良心血管事件(major cardiovascular events,MACE)发生率与动态PP、DBP和糖尿病有关[OR分别1.043(95%CI1.038-1.163),-1.014(95%CI-1.138-1.013),1.011(95%CI0.008-1.023)],远期MACE发生率与糖尿病史、心梗史有关[OR分别为1.126(95%CI 1.067-1.232),1.121(95%CI 1.044-1.241)]。结论:动态PP是最为方便的反映动脉僵硬的参数,与PCI围手术期及远期MACE发生率增加密切相关,可作为全身心血管疾病的一个危险信号,指导早期干预。
Objective：To investigate the value of pulse pressure levels in risk stratification outcomes evaluation in senile patients with essension hypertension who received Percutaneous Coronary Intervention （PCI）. Methods：We studied 138 consecutive patients who received PCI. Brachial Systolic and diastolic blood pressure were measured. The severity of coronary artery stenosis was shown as the score of coronary artery. According to PP 〉 60 mm Hg they were divided into the following groups ： PP 〉 60 mm Hg group （52 cases） and PP≤60mmHg group （86 cases）. The clinical characteristics and major cardiovascular event （MACE） at follow- up period of a meanl8.6 ± 4.3 months were analyzed. Results： The percentage of older patients ,male, hypertension, diabetes, type C lesion, three artery and the score of coronary artery were higher in PP 〉60mmHg group compared with those in PP≤60mmHg group. （ all P 〈 0.05 =. The incidence of in - hospital non - fatal myocardial infarction and cardiac mortality was significantly higher in PP 〉 60mmHg group than that in PP≤60mmHg group. （ respectively 16.8% vs8.8% ,5.2% vs2.3% and 1.3% vs0.8% , all P 〈 0.05 ） . Multi -logistic analysis showed that incidences of in -hospital MACE were related to PP,DBP and diabetes . OR were respectively 1. 043 （95 % CI 1. 038 - 1.163 ）, - 1. 014 （ 95 % CI - 1.138 - 1.013 ） , 1.011 （ 95 % CI 0.008 - 1. 023 ）. Incidences of MACE were relationship with diabetes and myocardial infarction. OR were respectively 1. 126 （95% CI 1. 067 - 1. 232 ） , 1. 121 （ 95% CI 1. 044 - 1. 241 ）. Conclusions： Pulse pressure was the simplest parameter reflecting large artery elasticity and closely related to the severity of coronary artery stenosis. PP was associated with the increases in incidences of MACE and procedure - related complication. This pa- rameter could be a marker of cardiovascular risk, instructing early intervention.
出处
《中国民康医学》
2007年第15期620-622,624,共4页
Medical Journal of Chinese People’s Health
关键词
高血压
动态脉压
冠脉介入
预后
老年
Essension Hypertension：Ambulatory pulse pressure
Percutaneous Coronary Intervention
prognosis
senile
