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目的探讨顽固性高血压合并冠心病患者经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)后能有效降压的原因,以提高对顽固性高血压综合治疗的认识。方法回顾2006年1月-2010年11月在玉林红十字会医院诊治的12例顽固性高血压合并冠心病经PCI治疗后能有效降压患者的临床资料,并结合相关文献进行分析。结果冠脉造影结果提示12例患者中,3例存在三支病变,3例两支病变,6例单支病变,狭窄程度75%～完全闭塞。所有患者均成功行PCI治疗,植入支架数1～5枚,平均(2.3±1.2)枚。PCI后12例患者血压控制在(89～138)/(64～83)mm Hg之间,平均收缩压(121±12)mm Hg,平均舒张压(69±6)mm Hg。所有患者血压均得到有效控制,有效率100%。结论顽固性高血压合并冠心病患者,血压控制不佳时,可考虑先行PCI治疗。
Objective To investigate the causes of hypertension in patients with refractory hypertension complicated with coronary heart disease after percutaneous coronary intervention (PCI), so as to improve the understanding of refractory hypertension. Methods The clinical data of 12 patients with refractory hypertension complicated with coronary heart disease treated by PCI at Yulin Red Cross Hospital from January 2006 to November 2010 were retrospectively analyzed and analyzed with related literatures. Results The results of coronary angiography showed that there were 3 lesions in 3 patients, 3 lesions in 2 lesions, 6 lesions in one branch, and 75% occlusion in 12 lesions. All patients were successfully treated with PCI, the number of stent implantation 1 to 5, with an average of (2.3 ± 1.2) pieces. The mean systolic pressure (121 ± 12) mm Hg, mean diastolic pressure (69 ± 6) mm Hg) were obtained in 12 patients after PCI. Blood pressure was controlled between (89- 138) / (64-83) mm Hg. All patients have been effectively controlled blood pressure, effective rate of 100%. Conclusion Refractory hypertension with coronary heart disease, poor blood pressure control, may consider the first PCI treatment.