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目的研究原发性高血压合并冠状动脉性心脏病(冠心病)患者血浆脑钠尿肽与冠状动脉狭窄性病变程度的关系。方法从资料完整的原发性高血压患者中,据脑钠尿肽定量(正常值<100ng/L)结果分为脑钠尿肽阳性组(173例),从脑钠尿肽阴性患者中选择和阳性组血压匹配者(170例)作为阴性对照组进行分析,比较两组患者冠状动脉造影显示的冠状动脉狭窄支数与冠状动脉Gensini积分。结果冠状动脉造影显示,原发性高血压患者冠心病发生率在脑钠尿肽阳性组(149/173,86.1%)明显高于阴性组(97/170,57.1%),且双支病变发病率较高(24.3%比14.1%,P<0.01),三支病变发病率也较高(13.9%比2.9%,P<0.01);在脑钠尿肽阳性组,冠状动脉Gensini积分高于阴性组[(36.8±7.5)比(24.1±5.8),P<0.05]。结论在原发性高血压患者中,脑钠尿肽阳性者比阴性者有更高的冠心病发生率和更加严重的冠状动脉狭窄性病变。
Objective To investigate the relationship between plasma brain natriuretic peptide and coronary artery stenosis in patients with essential hypertension complicated with coronary heart disease (CHD). Methods According to the quantification of brain natriuretic peptide (normal value <100ng / L) in patients with intact primary hypertension, the patients were divided into brain natriuretic peptide positive group (173 cases) and brain natriuretic peptide negative patients (170 cases) as the negative control group, and the coronary artery stenosis count and coronary artery Gensini score were compared between the two groups. Results Coronary angiography showed that the incidence of coronary heart disease in patients with essential hypertension was significantly higher in patients with brain natriuretic peptide (149/173, 86.1%) than in patients with negative hypertension (97/170, 57.1%), (24.3% vs 14.1%, P <0.01). The incidence of three lesions was also higher (13.9% vs 2.9%, P <0.01). In the brain natriuretic peptide positive group, the Gensini score of coronary artery was higher than negative Group [(36.8 ± 7.5) vs (24.1 ± 5.8), P <0.05]. Conclusion In patients with essential hypertension, patients with positive brain natriuretic peptide have a higher incidence of coronary heart disease and more severe coronary artery stenosis than those with negative brain natriuretic peptide.