【摘要】 目的　探讨高血压伴心绞痛 ,缺血性ST—T改变患者冠状动脉病变与心肌肥厚及血脂的关系。方法　选择平均年龄5 8.5± 7.43岁具有典型心绞痛或非典型心绞痛 ,心电图或动态心电图ST—T有缺血性改变的高血压患者 176例进行冠状动脉造影 (CAG) ,心脏B超及血脂检查。结果　 (1) 176例中冠状动脉狭窄 (CAS)者 6 1.36 %;冠状动脉正常 (CAN)者 38.6 3%。两组年龄无统计学差异。 (2 )CAS组舒张压高于CAN组 (P <0 .0 5 ) ;LVS及PW厚度两组间无统计学差异。 (3)CAS组TG ,LDL ,LP(a)高于CAN组。 (4)心律失常发生率CAS组 44.40 %,CAN组 38.88%。结论　高血压所致的冠状动脉大、中动脉病变仍是导致临床心绞痛及缺血性ST—T改变的主要因素 ;一部分冠状动脉正常者但临床有症状者主要与冠状动脉细小分支支数减少导致冠状动脉储备血流下降及心肌内小或微血管病变与肥厚心肌不同步发展有关。血压高 ,血脂异常是促进冠状动脉的主要因素之一 ,心律失常的发生与高血压致心肌肥厚改变 ,心肌应激性增高有关。进一步研究高血压心肌微血管病变的检测手段及微血管病变逆转的途径是高血压防治又一重要环节。更多还原

【Abstract】 Objective To investigate the relationship between coronary artery disease and myocardial hypertrophy and blood fat in patients with hypertension. Methods The coronary angiography, 2 - D echocardiography and lipid of 176 cases with EH (age 58.5±7.43, with typical or atypical angina pectoris, ST-T on electrocardiogram showed ischemic changes) was examined. Results (1) Coronary artery stenosis (CAS) was 61.36%, and coronary artery normal (CAN) was 31.63%. There was no difference in the age in two groups. (2) Diastolic pressure in CAS group was higher than that in CAN group (P<0.05). There was no difference in Left ventricular septum (LVS) and posterior wall (PW) in two groups. (3) TC, LDL and Lp (a) in CAS group was higher than that in CAN group. (4) The incidence of arrhythmia was 44.4% (in CAS group) and 38.88 (in CAN group) respectively. Conclusions Coronary artery (middle and large) stenosis was the main reason causing pectoris and ST-T ischemic changes. The symptoms in coronary artery normal patients were related mainly to small and micro vessels decrease, coronary flow reserve decrease. Hypertension and hyperlipemia are the main factors leading to coronary artery disease. Arrhythmia is mainly related to myocardial hypertrophy caused by hypertension and the increase of myocardial excitability.更多还原