摘要
目的对老年原发性高血压(高血压)患者冠状动脉微循环指数变化及可能的影响因素展开分析。方法 2016年5月至2017年4月收集雅安市人民医院符合研究标准的36例老年高血压患者作为实验组,同期遵循配对原则选择36例非高血压老年患者作为对照组。两组患者均因胸痛、胸闷等冠状动脉粥样硬化性心脏病(冠心病)症状就诊,实施冠状动脉造影及冠状动脉功能检测,重点观察两组冠状动脉微循环指数变化,并结合其他检查结果探讨可能的影响因素。结果两组空腹血糖、三酰甘油(triacylglycerol,TG)、总胆固醇(total cholesterol,TC)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)浓度比较,差异无统计学意义(P>0.05);实验组低密度脂蛋白胆固醇(low-density lipoprotein-cholesterol,LDL-C)浓度明显低于对照组,而血浆黏度、血沉、血清高敏C反应蛋白、24 h尿蛋白定量明显高于对照组,差异有统计学意义(P<0.05);实验组左心室射血分数、左心室质量、左心室质量指数、左心室舒张功能减退、冠状动脉血流储备、冠状动脉微循环阻力指数、基线平均传导时间、平均冠状动脉内压力、最大充血状态下平均传导时间等指标与对照组比较,差异有统计学意义(P<0.05)。以冠状动脉微循环阻力指数变化作为应变量行多因素Logistic回归分析,结果提示LDL-C、血浆黏度、血沉、血清高敏C反应蛋白、24 h尿蛋白定量、左心室质量指数、舒张功能减退等因素可能是冠状动脉微循环阻力指数异常改变的影响因素。结论老年高血压患者发生冠状动脉微循环阻力指数异常改变,应从血脂浓度、血浆黏度、炎症情况、肾功能、心脏功能等方面加强干预,以改善冠状动脉功能,降低并发症。
Objectives To analyze the changes of coronary circulation index and possible influencing factors in elderly patients with hypertension.Methods From May2016to April2017,36elderly hypertensive patients with clinical data meeting the study criteria were collected as experimental group,and36cases of non elderly hypertensive patients as control group.Patients in the two groups were with chest pain,chest tightness and other symptoms of coronary heart disease.Coronary angiography and percutaneous coronary function were tested,focusing on changes of coronary microcirculation index in the patients of the two groups,and in combination with other possible factors influencing coronary microcirculation index from test results were explored.Results There were no significant differences between concentrations of fasting blood glucose,total cholesterol,triglyceride,high density lipoprotein cholesterol of the two groups(P>0.05);concentration of low density lipoprotein cholesterol of experimental group was significantly lower than that of control group(P<0.05).Plasma viscosity,erythrocyte sedimentation rate,serum high-sensitivity C reactive protein,24h urinary protein of experimental group were significantly higher than those of control group(P<0.05).Differences of left ventricular ejection fraction,left ventricular mass,left ventricular mass index,left ventricular diastolic function,coronary flow reserve,coronary microcirculation resistance index,baseline average conduction duration,maximal hyperemia average conduction duration and average coronary pressure index between experimental group and control group were statistically significant(P<0.05).Multivariate Logistic regression analysis showed that low density lipoprotein cholesterol,plasma viscosity,erythrocyte sedimentation rate,serum high sensitivity C reactive protein,24h urinary protein quantitation,left ventricular mass index and diastolic function may be the influencing factors of abnormal change of coronary microcirculation resistance index.Conclusions The abnormal changes of coronary microcirculation resistance index in elderly hypertensive patients including blood lipid,plasma viscosity,inflammation,renal function and cardiac function should be strengthened,so as to improve coronary function and reduce complications.
作者
李建强
余佳欣
康林
LI Jian-qiang;YU Jia-xin;KANG Lin(Department of Geriatric Disease,Ya′an People′s Hospital,Ya′an,Sichuan 625000,China;Department of Integration of Traditional Chinese and Western Medicine,Ya′an People′s Hospital,Ya′an,Sichuan 625000,China)
出处
《岭南心血管病杂志》
2018年第6期675-679,共5页
South China Journal of Cardiovascular Diseases
关键词
高血压
冠状动脉疾病
冠状动脉微循环指数
冠状动脉造影
影响因素
hypertension
coronary heart disease
coronary microcirculation index
coronary angiography
influencing factors
