摘要
目的探讨血压变异性(blood pressure variability,BPV)及血尿酸浓度联合预测急性心肌梗死(acutemyocardial infarction,AMI)冠状动脉(冠脉)病变严重程度及近期预后的价值。方法选取2015年3月至2016年3月在惠州市第三人民医院经冠脉造影确诊的AMI患者72例为AMI组,另选取30名同期行健康查体者为对照组。动态检测两组血压并计算其白天、夜间和24 h的舒张压变异性(dDSD、nDSD、24 h DSD)及白天、夜间和24 h收缩压变异性(dSSD、nSSD、24 h SSD),酶比色法检测两组血尿酸浓度,采用冠脉造影检查所得的Gen-sini积分评价其冠脉病变严重程度,并统计AMI组28 d病死率。比较Gensini积分<30分和Gensini积分≥30分患者的BPV和血尿酸浓度以及不同预后情况患者的BPV和血尿酸浓度,并采用受试者工作特征(receiver opera-tor characteristic,ROC)曲线分析BPV和血尿酸浓度联合预测AMI冠脉病变严重程度及近期预后的价值。结果与对照组比较,AMI组的BPV及血尿酸浓度均升高,差异有统计学意义(P<0.05)。AMI组28 d病死率、Gensini积分<30分患者比例和Gensini积分≥30分患者比例分别为15.28%、55.56%和44.44%,且死亡患者的BPV和血尿酸浓度均较存活患者高,Gensini积分≥30分患者的BPV和血尿酸浓度均较Gensini积分<30分患者升高,差异有统计学意义(P<0.05)。ROC曲线分析结果显示,BPV和血尿酸浓度联合预测AMI冠脉病变严重程度及近期预后的价值良好。结论 BPV及血尿酸浓度联合预测AMI冠脉病变严重程度及近期预后的价值良好,联合检测血BPV及血尿酸可能作为其病情和近期预后评估的参考指标。
Objectives To investigate the value of blood pressure variability（BPV）combined blood uric acid concentrationon predicting coronary artery lesion severity and short-term prognosis of acute myocardial infarction（AMI）. Methods Totally 72 patients with AMI confirmed by coronary angiography in The Third People＇s Hospital of Huizhou City fromMarch 2015 to March 2016 were selected as AMI group,and the other 30 healthy persons had physical examinationwere selected as control group. Blood pressure of the two groups was dynamically detected and the day,night and 24 hdiastolic blood pressure variability（dDSD,nDSD,24 h DSD）and the day,night and 24 h systolic blood pressurevariability（dSSD,nSSD,24 h SSD） were calculated. Enzyme colorimetry was applied to detect blood uric acidconcentrations in both groups. Gensini score revealed by coronary angiography was applied in evaluation of the severity ofcoronary lesions. 28 d mortality of AMI group was statistically analyzed. BPV and blood uric acid concentration ofpatients with Gensini score 〈30 and Gensini score ≥ 30 were compared and BPV and blood uric acid concentration inpatients with different prognosis were compared. Receiver operator characteristic（ROC）curve was applied in analyzingthe value of BPV combined blood uric acid concentration on predicting coronary artery lesion severity and short-termprognosis of AMI. Results Compared with control group,BPV and blood uric acid concentration in AMI group were significantly higher（P〈0.05）. 28 d mortality,patients percentage of Gensini score〈30 and patients percentage ofGensini≥ 30 were 15.28%,55.56% and 44.44%,respectively. BPV and blood uric acid concentrations of the deathpatients were higher than that of the survival patients,and BPV and blood uric acid concentrations of the patients withGensini score≥ 30 were higher than that of patients with Gensini score30（P〈0.05）. ROC curve analysis results showedthat value of BPV combined blood uric acid concentration on predicting coronary artery
作者
刘凌
刘锦全
LIU Ling LIU Jin-quan(Department of Cardiovascular Internal Medicine, The Third People＇s Hospital of Huizhou City, Huizhou, Guangdong 516002, China)
出处
《岭南心血管病杂志》
2017年第3期254-257,269,共5页
South China Journal of Cardiovascular Diseases
基金
惠州市科技计划项目(项目编号:20150801)
关键词
心肌梗死
冠状动脉病变
血压变异性
血尿酸
联合
预测
近期预后
myocardial infarction
coronary artery lesion
blood pressure variability
blood uric acid
combined
predict
recent prognosis
