不同血壓水平下AASI與冠狀動(dòng)脈病變的相關(guān)性研究
發(fā)布時(shí)間：2018-09-06 13:26
【摘要】：研究目的:眾所周知,高血壓是冠心病的獨(dú)立危險(xiǎn)因素。血壓升高引起的血流動(dòng)力學(xué)變化以及應(yīng)切力的改變導(dǎo)致血管內(nèi)皮的損傷,血管的彈力纖維斷裂從而加速血管粥樣硬化。動(dòng)態(tài)動(dòng)脈硬化指數(shù)是利用24小時(shí)動(dòng)態(tài)血壓的監(jiān)測數(shù)據(jù)計(jì)算出的一種評價(jià)動(dòng)脈硬化程度的指標(biāo)。AASI是一種有效的、無創(chuàng)的檢測動(dòng)脈功能的方法。很多研究表明AASI與冠狀動(dòng)脈病變密切相關(guān),但是對不同血壓水平下AASI與冠脈病變的相關(guān)性卻尚未見報(bào)導(dǎo)。本研究通過AASI與CAG結(jié)果進(jìn)行比較,以CAG為依據(jù),明確每種血壓水平下冠脈病變與非病變組AASI值的差異。明確三種血壓水平下AASI與冠脈病變的相關(guān)性是怎樣的,評估無創(chuàng)性檢查方式動(dòng)態(tài)血壓在診斷CHD中的價(jià)值及應(yīng)用前景,為臨床上CHD的無創(chuàng)性診斷提供指導(dǎo)。研究方法:本研究選取石河子大學(xué)第四附屬醫(yī)院心血管內(nèi)科2011年6月至2016年9月可疑CHD住院患者425例為研究對象。所有對象先后均行ABPM檢測及CAG術(shù),計(jì)算425例患者AASI值。根據(jù)冠脈病變的結(jié)果將425例研究分成五組分別為:血壓正常組、正常血壓高值組、高血壓一級組、高血壓二級組、高血壓三級組。再分別將各組再分為冠脈正常組以及冠脈病變組,探討五組血壓水平下AASI與冠脈病變的相關(guān)性。行動(dòng)態(tài)血壓監(jiān)測,白晝(08:00-20:00)每15分鐘測量一次,夜間(20:00-08:00)每30分鐘測量一次,測量有效次數(shù)85%為有效測量,且每小時(shí)區(qū)間有效讀數(shù)無缺漏。測量記錄的有效血壓度數(shù)標(biāo)準(zhǔn)和舍棄標(biāo)準(zhǔn):收縮壓70-260mm Hg(1mm Hg=0.133k Pa),舒張壓40-150mm Hg,脈壓20-150mm Hg,排除不符合上述標(biāo)準(zhǔn)的患者即:收縮壓260mm Hg或70mm Hg,舒張壓150mm Hg或40mm Hg,脈壓差150mm Hg或20mm Hg.觀察指標(biāo):24h平均收縮壓(24h SBP)/平均舒張壓(24h DBP)。動(dòng)態(tài)動(dòng)脈硬化指數(shù)(AASI)=1-收縮壓與舒張壓直線回歸的斜率。統(tǒng)計(jì)分析采用采用SPSS 17.0軟件進(jìn)行數(shù)據(jù)處理,計(jì)量資料用均數(shù)±標(biāo)準(zhǔn)差(x±s)表示,均進(jìn)行正態(tài)分布方差齊性檢驗(yàn),兩組間比較采用t檢驗(yàn);多組間比較采用單因素方差分析,指標(biāo)相關(guān)性分析采用Spearman相關(guān)分析,P0.05為差異有統(tǒng)計(jì)學(xué)意義。結(jié)果:各血壓水平組冠脈病變組的AASI均大于各血壓水平組冠脈組正常組AASI,差異具有統(tǒng)計(jì)學(xué)意義(p0.05)。隨著血壓水平的升高AASI在各血壓水平組冠脈病變組、冠脈正常組均逐漸升高,差異具有統(tǒng)計(jì)學(xué)意義(p0.05)。年齡、正常血壓高值、高血壓、AASI與冠心病呈正相關(guān)(P0.05).結(jié)論:1.在同一血壓水平,冠脈病變組AASI大于冠脈正常組。2.隨著血壓水平的升高,動(dòng)態(tài)動(dòng)脈硬化指數(shù)(AASI)無論在冠脈病變組以及冠脈正常組均升高,冠脈病變風(fēng)險(xiǎn)增加。
[Abstract]:Objective: it is well known that hypertension is an independent risk factor for coronary heart disease. The changes of hemodynamics caused by high blood pressure and the change of shearing force lead to the injury of vascular endothelium and the rupture of elastic fiber of blood vessel, which accelerates atherosclerosis. Dynamic arteriosclerosis index (AASI) is an effective and noninvasive method for detecting arterial function, which is calculated by 24 hours ambulatory blood pressure monitoring data. AASI is an effective and noninvasive method to evaluate the degree of arteriosclerosis. Many studies have shown that AASI is closely related to coronary artery disease, but the correlation between AASI and coronary artery disease at different blood pressure levels has not been reported. In this study, the results of AASI and CAG were compared, and based on CAG, the difference of AASI value between coronary artery lesion and non-lesion group was determined at each blood pressure level. To determine the correlation between AASI and coronary artery disease at three blood pressure levels, to evaluate the value and application prospect of noninvasive ambulatory blood pressure (ABBP) in the diagnosis of CHD, and to provide guidance for clinical noninvasive diagnosis of CHD. Methods: a total of 425 patients with suspected CHD from June 2011 to September 2016 in Cardiovascular Department of the fourth affiliated Hospital of Shihezi University were selected as the study subjects. All subjects were examined by ABPM and CAG successively, and the AASI values of 425 patients were calculated. According to the results of coronary artery disease, 425 cases were divided into five groups: normal blood pressure group, normal blood pressure high value group, hypertension first class group, hypertension second class group, hypertension third class group. Then each group was subdivided into normal coronary artery group and coronary artery disease group, to explore the correlation between AASI and coronary artery disease at blood pressure level. Ambulatory blood pressure monitoring was carried out every 15 minutes during the day (08: 00-20: 00) and every 30 minutes at night (20: 00-08: 00). The effective number of measurements was 85%. Effective blood pressure measure and abandonment criteria: systolic blood pressure 70-260mm Hg (1mm Hg=0.133k Pa), diastolic pressure 40-150mm Hg, pulse pressure 20-150mm Hg, exclusion of patients who do not meet the above criteria: systolic blood pressure 260mm Hg or 70mm Hg, diastolic blood pressure 150mm Hg or 40mm Hg, pulse pressure difference 150mm Hg or 20mm Hg. An observational measure of 24 hours mean systolic blood pressure (24 h SBP) / mean diastolic blood pressure (24 h DBP).) Dynamic arteriosclerosis index (AASI) 1-slope of linear regression between systolic and diastolic blood pressure. The statistical analysis was conducted by SPSS 17.0 software, and the measurement data were expressed as mean 鹵standard deviation (x 鹵s). The homogeneity test of normal distribution variance was carried out, the t test was used for the comparison between the two groups, and the single factor analysis of variance was used for the comparison between the two groups. Index correlation analysis using Spearman correlation analysis (P0.05) was statistically significant. Results: the AASI of coronary artery lesion group in each blood pressure group was higher than that of normal coronary artery group in each blood pressure level group (p0. 05). With the increase of blood pressure, AASI increased gradually in the coronary artery lesion group and the normal coronary artery group in each blood pressure level group, the difference was statistically significant (p0. 05). Age, normal blood pressure and AASI were positively correlated with coronary heart disease (P0.05). Conclusion 1. At the same blood pressure level, AASI in the coronary lesion group was higher than that in the normal coronary artery group. 2. 2. With the increase of blood pressure, the dynamic arteriosclerosis index (AASI) increased in both the coronary artery lesion group and the normal coronary artery group, and the risk of coronary artery lesion increased.
【學(xué)位授予單位】：石河子大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R544.1
本文編號：2226481
[Abstract]:Objective: it is well known that hypertension is an independent risk factor for coronary heart disease. The changes of hemodynamics caused by high blood pressure and the change of shearing force lead to the injury of vascular endothelium and the rupture of elastic fiber of blood vessel, which accelerates atherosclerosis. Dynamic arteriosclerosis index (AASI) is an effective and noninvasive method for detecting arterial function, which is calculated by 24 hours ambulatory blood pressure monitoring data. AASI is an effective and noninvasive method to evaluate the degree of arteriosclerosis. Many studies have shown that AASI is closely related to coronary artery disease, but the correlation between AASI and coronary artery disease at different blood pressure levels has not been reported. In this study, the results of AASI and CAG were compared, and based on CAG, the difference of AASI value between coronary artery lesion and non-lesion group was determined at each blood pressure level. To determine the correlation between AASI and coronary artery disease at three blood pressure levels, to evaluate the value and application prospect of noninvasive ambulatory blood pressure (ABBP) in the diagnosis of CHD, and to provide guidance for clinical noninvasive diagnosis of CHD. Methods: a total of 425 patients with suspected CHD from June 2011 to September 2016 in Cardiovascular Department of the fourth affiliated Hospital of Shihezi University were selected as the study subjects. All subjects were examined by ABPM and CAG successively, and the AASI values of 425 patients were calculated. According to the results of coronary artery disease, 425 cases were divided into five groups: normal blood pressure group, normal blood pressure high value group, hypertension first class group, hypertension second class group, hypertension third class group. Then each group was subdivided into normal coronary artery group and coronary artery disease group, to explore the correlation between AASI and coronary artery disease at blood pressure level. Ambulatory blood pressure monitoring was carried out every 15 minutes during the day (08: 00-20: 00) and every 30 minutes at night (20: 00-08: 00). The effective number of measurements was 85%. Effective blood pressure measure and abandonment criteria: systolic blood pressure 70-260mm Hg (1mm Hg=0.133k Pa), diastolic pressure 40-150mm Hg, pulse pressure 20-150mm Hg, exclusion of patients who do not meet the above criteria: systolic blood pressure 260mm Hg or 70mm Hg, diastolic blood pressure 150mm Hg or 40mm Hg, pulse pressure difference 150mm Hg or 20mm Hg. An observational measure of 24 hours mean systolic blood pressure (24 h SBP) / mean diastolic blood pressure (24 h DBP).) Dynamic arteriosclerosis index (AASI) 1-slope of linear regression between systolic and diastolic blood pressure. The statistical analysis was conducted by SPSS 17.0 software, and the measurement data were expressed as mean 鹵standard deviation (x 鹵s). The homogeneity test of normal distribution variance was carried out, the t test was used for the comparison between the two groups, and the single factor analysis of variance was used for the comparison between the two groups. Index correlation analysis using Spearman correlation analysis (P0.05) was statistically significant. Results: the AASI of coronary artery lesion group in each blood pressure group was higher than that of normal coronary artery group in each blood pressure level group (p0. 05). With the increase of blood pressure, AASI increased gradually in the coronary artery lesion group and the normal coronary artery group in each blood pressure level group, the difference was statistically significant (p0. 05). Age, normal blood pressure and AASI were positively correlated with coronary heart disease (P0.05). Conclusion 1. At the same blood pressure level, AASI in the coronary lesion group was higher than that in the normal coronary artery group. 2. 2. With the increase of blood pressure, the dynamic arteriosclerosis index (AASI) increased in both the coronary artery lesion group and the normal coronary artery group, and the risk of coronary artery lesion increased.
【學(xué)位授予單位】：石河子大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R544.1
【參考文獻(xiàn)】
相關(guān)期刊論文 前10條
1 陳利佳;吳敏;馮延歡;黃佑群;臧麗;付平;劉芳;;糖尿病腎臟疾病動(dòng)脈硬化指數(shù)及其影響因素分析[J];四川大學(xué)學(xué)報(bào)(醫(yī)學(xué)版);2015年01期
2 王會弟;甄圣龍;游向東;;原發(fā)性高血壓患者動(dòng)態(tài)動(dòng)脈硬化指數(shù)與頸動(dòng)脈內(nèi)-中膜厚度的相關(guān)性研究[J];河北中醫(yī);2014年11期
3 張丁丁;黃建鳳;;動(dòng)態(tài)動(dòng)脈硬化指數(shù)研究進(jìn)展[J];心血管病學(xué)進(jìn)展;2014年04期
4 喬麗靜;張平安;梅永現(xiàn);宋利云;;冠心病患者AASI與微量白蛋白尿的關(guān)系[J];河北醫(yī)藥;2014年06期
5 蘆軍;趙偉麗;孫曉紅;崔其福;;動(dòng)態(tài)動(dòng)脈硬化指數(shù)與顱內(nèi)、外動(dòng)脈狹窄的相關(guān)性研究[J];實(shí)用醫(yī)學(xué)雜志;2014年05期
6 馬衛(wèi)武;;動(dòng)脈硬化動(dòng)態(tài)指數(shù)與冠狀動(dòng)脈病變的相關(guān)性分析[J];陜西醫(yī)學(xué)雜志;2013年08期
7 王燕俠;梁杰;;老年原發(fā)性高血壓頸動(dòng)脈粥樣硬化患者動(dòng)態(tài)動(dòng)脈硬化指數(shù)的變化及意義[J];中國老年學(xué)雜志;2013年08期
8 韓燁;陳吉;張淑靜;;老年收縮期高血壓動(dòng)態(tài)動(dòng)脈硬化指數(shù)與左心房內(nèi)徑相關(guān)性研究[J];人民軍醫(yī);2013年03期
9 曹瑞華;葉平;秦愛梅;;動(dòng)態(tài)動(dòng)脈硬化指數(shù)的影響因素分析[J];中華保健醫(yī)學(xué)雜志;2012年01期
10 杜國峰;張志敏;向文海;;中老年高血壓伴左室肥厚患者周圍動(dòng)脈硬化特點(diǎn)及相關(guān)性分析[J];實(shí)用老年醫(yī)學(xué);2012年01期
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