【摘要】 目的　探讨高血压患者脉压 (PP)水平与冠脉狭窄的关系。方法　回顾性分析 336例因胸痛住院接受冠脉造影且规则接受药物治疗下高血压病患者的脉压与冠脉狭窄的相关性。结果　①随着收缩压增高和舒张压的下降 ,脉压逐渐增大 ,冠状动脉狭窄级别、狭窄≥ 75 %血管支数和狭窄≥ 75 %的例数均明显增加 (P <0 .0 1)。②高血压病患者严重冠脉狭窄 (≥ 75 % )的发生与年龄、高血压病程和脉压相关 (P <0 .0 1) ,但与患者平均动脉压似无相关 (p >0 .0 5 )。③Logistic回归分析显示 ,PP与高血压病患者严重冠脉狭窄 (≥ 75 % )发生存在明显的相关性 ,PP每增加 10mmHg ,冠心病发生率增加 32 % (95 %CI :1.2 5～ 1.39,P <0 .0 0 0 1) ;在对年龄和高血压病程进行调整后 ,PP每增加 10mmHg仍显示增加冠心病发生率 2 1% (95 %CI:1.15～ 1.2 7,P <0 .0 0 0 1)。在其他血压参数中 ,收缩压 (SBP)同样与冠心病的发生密切相关。结论　高血压患者脉压水平与冠脉狭窄呈正相关关系 ,在降压治疗的同时 ,应缩小增大的脉压。更多还原

【Abstract】 Objective To investigate the relationship between pulse pressure (PP) and coronary stenosis in hypertension patients. Methods Parameters of blood pressure, clinical features and coronary angiographic findings were analyzed retrospectively in 336 patients with essential hypertension under standard antihypertensive treatment. Results ①coronary stenosis were increasing with PP raising( P <0.01). ②coronary stenosis(≥75%) has a positive correlation with age, duration of hypertention and pulse pressure( P < 0.01 )but no relationship with mean artery pressure. ③Logistic regression analysis showed that PP was strongly correlated with coronary stenosis(≥75%) in essential hypertensive patients, every 10mmHg increasing in PP was 32% increase in coronary heart disease(95%CI 1.25～1.39, P =0.0001) After adjusting for sex and duration of hypertension, every 10mmHg increasing in PP was 21% increase in coronary heart disease risk(95%CI:15%～27%, P <0.0001) were observed. Conclusions The pulse pressure has a positive correlation with coronary stenosis .In order to decrease the cardiac damages of hypertension, during lower blood pressure treatment, more attentions should be put on pulse pressure.更多还原