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目的研究动态血压相关指标对冠心病患者新心血管事件的预测价值。方法选择2011年5月~2013年5月,余姚市人民医院确诊冠心病患者255例,均行动态血压检测,定期进行随访,记录患者心脑血管事件发生情况,采用Cox比例风险回归分析探讨影响心血管事件的因素。结果观察组患者年龄、糖尿病、高血压、吸烟比例均高于对照组,差异有统计学意义(P<0.05)。观察组患者24h平均收缩压(142.2±15.5)mm Hg、24h平均动态舒张压(95.6±8.6)mm Hg、24h平均脉压(78.2±11.5)mm Hg、动态脉压指数(0.68±0.06)均高于对照组患者,差异有统计学意义(t=4.17、4.68、3.38、7.38,均P<0.05)。动态脉压指数(PPI)上升0.1(P=0.014)、24h平均收缩压(MSBP)上升10mm Hg(P=0.04)、24h平均脉压(MPP)上升10mm Hg(P=0.012)是患者心血管事件的独立风险因素。结论动态血压相关指标有助于预测冠心病患者心血管事件,值得临床运用。
Objective To study the predictive value of ambulatory blood pressure related to new cardiovascular events in patients with coronary heart disease. Methods From May 2011 to May 2013, 255 patients with coronary heart disease diagnosed in Yuyao People’s Hospital were enrolled in this study. All patients underwent ambulatory blood pressure testing. Regular follow-up was performed to record the occurrence of cardiovascular and cerebrovascular events. Cox proportional hazards regression analysis was performed to investigate the impact Factors of cardiovascular events. Results The age, diabetes mellitus, hypertension and smoking in the observation group were significantly higher than those in the control group (P <0.05). The average systolic blood pressure (24h), 24h average systolic pressure (95.6 ± 8.6) mm Hg, 24h mean systolic pressure (78.2 ± 11.5) mm Hg and 0.68 ± 0.06 Higher than the control group patients, the difference was statistically significant (t = 4.17,4.68,3.38,7.38, all P <0.05). The mean arterial pressure (PPI) increased 0.1 (P = 0.014), the mean systolic blood pressure (MSBP) increased by 10 mm Hg (P = 0.04) and the mean MPP increased by 10 mm Hg Independent risk factors for events. Conclusions The indexes of ambulatory blood pressure can be used to predict the cardiovascular events in patients with coronary heart disease, which is worthy of clinical application.