【摘要】 目的探讨原发性高血压患者发生急性心肌梗死(AMI)后血压水平的变化、临床特点以及冠状动脉病变特点。方法175例AMI患者按发病前有无高血压分为高血压组(101例)和非高血压组(74例),比较两组患者发生AMI后的血压变化、临床特点以及冠状动脉造影结果。结果高血压组患者既往心肌梗死(15·84%)及脑卒中(23·76%)病史率均较非高血压组患者高。无痛性心肌梗死发生率在高血压组为23·76%,高于非高血压组(10·81%,P<0·05)。AMI后血压下降的发生率:高血压组为83·17%,非高血压组为28·37%,差别有显著性意义(P<0·05)。收缩压下降值:高血压组为(32±14)mmHg,非高血压组为(12±9)mmHg,差别有显著性意义(P<0·05),舒张压下降值两组间无差异(P>0·05)。两组患者心功能分级的构成比间差别有显著性意义(P<0·05)。并发症发生率在高血压组高于非高血压组(P<0·05)。高血压组病变血管总数、双支及3支以上病变率均显著高于非高血压组,差别有显著性意义(P<0·05),高血压组患者中有32例(占本组病变的31·68%)为分叉病变,非高血压组患者中仅有10例(占本组病变的13·51%),差别有显著性意义(P<0·05),病变血管弯曲数在高血压组为(5·7±1·2)个,而在非高血压组为(2·1±0·5)个,差别有显著性意义(P<0·05)。结论原发性高血压患者发生AMI后血压下降的发生率、严重程度、并发症及病死率均高于非高血压组患者,其冠状动脉病变严重,病变范围广,血管弯曲及分叉病变较多。更多还原

【Abstract】 Objective To analyze the change of blood pressure,clinical characteristics and morphological features of the coronary artery in patients with primary hypertension combined with acute myocardial infarction (AMI).Methods 175 patients were divided into two groups:hypertension group (n=101) and non-hypertension group (n=74).The change of blood pressure,clinical features and morphological features of the coronary artery visualized in angiography were compared between tow groups.Results The history rate of myocardial infarction (15.84%) and stroke(23.76%) in hypertension group was higher than that in non-hypertension group.The incidence of myocardial infarction without pain in hypertension group was higher than that in non-hypertension group (P<0.05).The incidence of lowering blood pressure in hypertension group was higher than that in non-hypertension group (P<0.05).The average lowering systolic pressure in hypertension group was (32±14 ) mm Hg ,in non-hypertension it was (12±9 ) mm Hg .There was significant difference in the two groups (P<0.05).There was no significant difference in the average lowering diastolic pressure between two groups(P>0.05).The incidences of heart failure,serious cardiac arrhythmia,cardiogenic shock,re-infarction in hypertension group were significantly higher than that in non-hypertension group (P<0.05).The patients in hypertension group had a higher incidence of complication than that in non-hypertension group (P<0.05).The bifurcation lesion was found in 31.68% patients in hypertensive group,but only 13.51% in non-hypertension group,significant difference (P<0.05).There were (5.7±1.2 ) curved vessels in the hypertensive group,but only (2.1±0.5 ) in non-hypertension group,which showed significant difference between two groups (P<0.05).Conclusion The incidence of lowering blood pressure,severity,complications and in-hospital mortality in hypertension group after AMI are significantly higher than those in non-hypertencion group.The lesion of coronary vessel is sever in hypertension patients,who have more curved vessels and more bifurcation lesions compared with non-hypertension patients.更多还原