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目的:探讨原发性高血压(EH)伴左室肥厚(LVH)患者冠状动脉粥样硬化狭窄特点。方法:选择经过冠状动脉造影的EH患者566例,伴LVH者140例(LVH组),与单纯EH患者426例(对照组)对比分析冠状动脉粥样硬化狭窄的部位、狭窄的程度、狭窄的范围等的差异。结果:LVH组与对照组比较,LVH组患者发生冠状动脉粥样硬化狭窄的概率明显升高(P<0.01),其危险性增加5.09倍。同时,LVH组发生左前降支冠状动脉粥样硬化狭窄概率显著高于对照组(P<0.01),在其他部位冠状动脉粥样硬化狭窄程度2组比较差异无统计学意义(P>0.05)。LVH组冠状动脉狭窄患者运动平板试验的心肌缺血检出率为33.1%(42/127),而对照组冠状动脉狭窄患者的心肌缺血检出率为12.5%(35/280),P<0.05。在传统冠状动脉粥样硬化危险因素中,只有血压与LVH存在协同效应(P<0.05)。结论:EH伴LVH患者冠状动脉粥样硬化狭窄发生率显著升高,左前降支是主要狭窄部位,而且更易于发生心肌缺血。
Objective: To investigate the characteristics of coronary atherosclerosis in patients with essential hypertension (EH) and left ventricular hypertrophy (LVH). Methods: 566 patients with EH undergoing coronary angiography, 140 patients with LVH (LVH group) and 426 patients with simple EH (control group) were enrolled in this study. The location of coronary atherosclerosis, the degree of stenosis, Range and other differences. Results: Compared with the control group, the incidence of coronary atherosclerosis in patients with LVH was significantly increased (P <0.01), and the risk increased by 5.09 times. At the same time, the incidence of coronary atherosclerosis in the left anterior descending branch was significantly higher in the LVH group than in the control group (P <0.01). There was no significant difference in the degree of coronary atherosclerosis between the two groups (P> 0.05). The detection rate of myocardial ischemia in patients with coronary artery stenosis in LVH group was 33.1% (42/127), while that in control group was 12.5% (35/280) in patients with coronary artery stenosis, P < 0.05. Among the risk factors of coronary atherosclerosis, only systolic blood pressure and LVH existed (P <0.05). Conclusion: The incidence of coronary atherosclerosis in patients with EH and LVH is significantly increased. The left anterior descending artery is the main site of stenosis and myocardial ischemia is more likely to occur.