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目的探讨急性心肌梗死(AMI)患者治疗期间血压变异性和血尿酸的变化及其与冠脉Gensini积分的关系。方法选取72例AMI患者(AMI组),根据Gensini积分将患者分成低Gensini积分组(Gensini积分<30分,n=31)和高Gensini积分组(Gensini积分≥30分,n=41)。另选取72名同期同龄健康查体者为对照组。比较两组血压变异性、血尿酸水平和左室射血分数(LVEF)。采用Spearman法和Logistic多因素分析法对AMI患者的血压变异性和血尿酸与其Gensini积分、LVEF的关系。结果与对照组比较,AMI组治疗前后的血压变异性指标及血尿酸水平均升高,而LVEF则降低;与治疗前比较,治疗后AMI组的血压变异性指标及血尿酸水平均降低,而LVEF则升高。与高Gensini积分组比较,低Gensini积分组治疗前后的血压变异性指标及血尿酸水平降低,而LVEF则升高(P<0.05)。Spearman相关分析结果显示,AMI治疗期间血压变异性指标和血尿酸水平与其LVEF和Gensini积分均相关(P<0.05)。Logistic多元回归分析结果显示,AMI治疗期间血压变异性及血尿酸与其Gensini积分密切相关(P<0.05)。结论 AMI治疗期间血压变异性指标和血尿酸水平均较高,且均与其冠状动脉狭窄程度和心功能密切相关,这可能与BPV影响大动脉弹性和血尿酸刺激平滑肌细胞增生和引起内皮功能异常致使动脉硬化发生相关,AMI治疗期间血压变异性指标和血尿酸可作为其病情评估的参考指标。
Objective To investigate the changes of blood pressure variability and serum uric acid during the treatment of patients with acute myocardial infarction (AMI) and its relationship with coronary Gensini score. Methods Seventy-two patients with AMI (AMI group) were selected and divided into low Gensini score group (Gensini score <30, n = 31) and high Gensini score group (Gensini score≥30, n = 41) according to Gensini score. The other 72 healthy people of the same age were selected as the control group. Blood pressure variability, serum uric acid level and left ventricular ejection fraction (LVEF) were compared between the two groups. The relationship between blood pressure variability, serum uric acid, Gensini score and LVEF in AMI patients was analyzed by Spearman method and Logistic multivariate analysis. Results Compared with the control group, the indexes of blood pressure variability and serum uric acid level before and after treatment in AMI group increased, while the LVEF decreased. Compared with those before treatment, the indexes of blood pressure variability and serum uric acid in AMI group decreased LVEF is increased. Compared with the high Gensini score group, the indexes of blood pressure variability and serum uric acid level before and after treatment in low Gensini score group decreased, while LVEF increased (P <0.05). Spearman correlation analysis showed that the indexes of blood pressure variability and serum uric acid during AMI were correlated with LVEF and Gensini scores (P <0.05). Logistic multiple regression analysis showed that blood pressure variability and serum uric acid during AMI were closely related to Gensini scores (P <0.05). Conclusions The indexes of blood pressure variability and serum uric acid level during AMI are higher than those of the control group, which are closely related to the degree of coronary artery stenosis and cardiac function. This may be related to the fact that BPV affects the elasticity of arterial arteries and stimulates the proliferation of smooth muscle cells and the endothelial dysfunction caused by arteriosclerosis Sclerosis, AMI treatment during blood pressure variability and serum uric acid can be used as a reference indicator of disease evaluation.