H型高血压对冠心病患者预后的影响
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(广西玉林红十字会医院心血管内科,广西玉林市 537000)

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吕海权,学士,副主任医师,研究方向为心血管病的诊治,E-mail为13877569707@163.com。

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广西卫生厅计划课题(Z2012738);玉林市科学研究与技术开发计划项目(玉林科攻11069012)


Effect of H-type Hypertension on Prognosis of Patients with Coronary Heart Disease
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Cardiovascular Department, The Red Cross Hospital of Yulin, Yulin, Guangxi 537000, China)

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    摘要:

    目的 探讨H型高血压对冠心病患者预后的影响。方法 入选2011年8月至2013年6月在我院住院行冠状动脉造影明确诊断为冠心病患者735例,根据有无高血压和高同型半胱氨酸血症(HHcy)将患者分为H型高血压组、高血压组、HHcy组和对照组,对患者进行随访。比较不同组别之间的临床资料和预后情况。结果 H型高血压组生存时间较对照组明显降低(P<0.05),高血压组、HHcy组生存时间与对照组相比差异无统计学意义(P>0.05)。多因素Cox回归分析在调整了年龄、性别、吸烟、糖尿病、体质指数、血脂、肌酐、尿酸、冠状动脉病变支数、Gensini积分、左心室射血分数等其他因素后,H型高血压是主要不良心脑血管事件(MACCE)的独立危险因素(P=0.000)。与对照组相比,在调整了其他因素后,H型高血压组(HR 5.013,95%CI 2.728~9.213)、高血压组(HR 2.449,95%CI 1.226~4.892)和HHcy组(HR 1.958,95%CI 0.910~4.214)MACCE风险明显增加(均P<0.05),H型高血压组发生MACCE风险更大。结论 高血压和高同型半胱氨酸对冠心病患者的预后具有协同危害作用,临床上应重视对冠心病患者进行H型高血压的筛查和管理。

    Abstract:

    Aim To investigate the effect of H-type hypertension on prognosis of patients with coronary heart disease. Methods From August 2011 to June 3,5 patients with coronary heart disease diagnosed by coronary angiography in our hospital were included in this study. According to whether there were hypertension and hyperhomocysteinemia (HHcy), the patients were divided into H-type hypertension group, hypertension group, HHcy group and control group. All patients were followed up. The clinical data and prognosis of different groups were compared. Results The survival time in H-type hypertension group was significantly lower than that in control group (P<0.05). Compared with the control group, there was no significant difference in survival time of hypertension group and HHcy group (P>0.05). After adjusting for various factors such as age, sex, smoking, diabetes, body mass index, blood lipid, creatinine, uric acid, coronary artery lesions, Gensini score and left ventricular ejection fraction, multivariate Cox regression analysis showed that H-type hypertension was an independent risk factor for major adverse cardiac and cerebral event (MACCE) (P=0.000). After adjusting for other factors, compared with the control group, MACCE risk increased significantly in H-type hypertension group (HR 5.3,5%CI 2.728-9.213), hypertension group (HR 2.9,5%CI 1.226-4.892) and HHcy group (HR 1.8,5%CI 0.910-4.214). MACCE risk was greater in H-type hypertension group. Conclusions Hypertension and high homocysteine have synergistic effects on the poor prognosis of patients with coronary heart disease. We should pay more attention to the screening and management of H-type hypertension in patients with coronary heart disease.

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吕海权,雷敏,陆敏,杨桂强,黎伟,谭子烈,凌政. H型高血压对冠心病患者预后的影响[J].中国动脉硬化杂志,2016,24(4):396~400.

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  • 收稿日期:2015-03-16
  • 最后修改日期:2015-06-04
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  • 在线发布日期: 2016-06-30