【摘要】 目的探讨高血压合并冠状动脉粥样硬化性心病(CHD)患者的血压特点及与卒中的关系。方法对59例高血压病合并CHD患者和29例单纯CHD患者进行24h动态血压监测(ABPM),随访6～13个月,分析动态血压参数与发生心血管事件的相关性。所有患者行冠脉造影术,冠脉病变用病变的血管支数及Gensini积分表示。结果高血压合并CHD患者的心血管事件发生率高于单纯CHD患者(P<0.05)。高血压合并CHD患者中有心血管事件组的年龄、冠脉病变积分、24h动态收缩压(SBP)、日间动态SBP、夜间动态SBP、24h动态脉压(PP)、日间动态PP、夜间动态PP都高于无心血管事件组(P<0.05)。年龄、冠脉病变积分、24h动态SBP、夜间动态PP与心血管事件发生关系密切(P<0.05)。结论年龄、冠脉病变积分、24h动态SBP、夜间动态PP是高血压合并CHD患者心血管事件发生的危险因素,应对这些因素进行控制以减少高血压合并CHD患者的心血管事件的发生。更多还原

【Abstract】 Objective To investigate the characteristics of blood pressure and its relationship with the apoplexia in patients with hypertension complicated with coronary heart disease(CHD).Methods 59 patients with hypertension complicated with CHD and 29 patients with CHD alone received 24h ambulatory blood pressure monitoring(ABPM),all the patients were followed up for 6～13 months,and the correlation between ambulatory blood pressure and cardiovascular events was analyzed.All the patients underwent coronary angiography,and the coronary artery pathological changes were showed by the vessel number with pathological changes and Gensini scoring.Results The incidences of hypertensive cardiovascular events in patients with hypertension complicated with CHD were significantly higher than those in patients with coronary heart disease alone(P<0.05).The age,coronary artery score,24h dynamic systolic blood pressure(SBP),daytime dynamic SBP,night-time dynamic SBP,24h ambulatory pulse pressure(PP),day dynamic PP night PP in patients with hypertension complicated with CHD were significantly higher than those in patients with coronary heart disease alone(P<0.05).Multivariate Logistic regression analysis showed that age,coronary artery score,24h dynamic SBP,night PP were closely correlated with the incidence of cardiovascular events(P<0.05).Conclusion The patients’age,coronary artery score,24h dynamic SBP,night-time dynamic PP are the risk factors of occurrence of cardiovascular events in patients with hypertension complicated with CHD were significantly higher than those in patients with coronary heart disease alone,so we should control these factors in order to reduce the incidence of cardiovascular events.更多还原