冠心病患者血压控制水平现况

doi:10.12047/j.cjap.5599.2018.007

中国应用生理学杂志 ›› 2018, Vol. 34 ›› Issue (1): 23-27.doi: 10.12047/j.cjap.5599.2018.007

冠心病患者血压控制水平现况

张越^1,2, 王甜甜¹, 郭树理³, 韩丽娜⁴, 张丽⁴, 李小鹰⁴, 樊锦⁴

1. 解放军医学院, 北京 100853;
2. 解放军总医院海南分院, 三亚 572000;
3. 北京理工大学自动化学院, 北京 100081;
4. 解放军总医院南楼临床部心血管内科, 北京 100853

收稿日期:2017-05-15 修回日期:2017-11-23 出版日期:2018-01-28 发布日期:2018-06-19
通讯作者: 韩丽娜,Tel:13520183153;E-mail:hanlina3399111@sina.com E-mail:hanlina3399111@sina.com
基金资助:
科技部重点研发项目计划（2017YFF0207400，2017YFF0207402）

Current status of blood pressure control in patients with coronary heart disease

ZHANG Yue^1,2, WANG Tian-tian¹, GUO Shu-li³, HAN Li-na⁴, ZHANG Li⁴, LI Xiao-ying⁴, FAN Jin⁴

1. Medical School of Chinese PLA, Beijing 100853;
2. Hainan Branch of Chinese PLA General Hospital, Sanya 572000;
3. State Key Laboratory of Intelligent Control and Decision, School of Automation, Beijing Institute of Technology, Beijing 100081;
4. Department of Cardiovascular Internal Medicine, Nanlou Branch of Chinese PLA General Hospital, Beijing 100853, China

Received:2017-05-15 Revised:2017-11-23 Online:2018-01-28 Published:2018-06-19
Supported by:
科技部重点研发项目计划（2017YFF0207400，2017YFF0207402）

摘要/Abstract

摘要： 目的：评估目前我国冠心病患者血压控制水平，为冠心病的二级预防及进一步治疗提供指导依据。方法：收集2011~2014年在解放军总医院及海南分院心内科住院治疗的1 230例冠心病患者，分析不同手术方式：经皮冠状动脉介入治疗（PCI）、冠状动脉旁路移植术（CABG）、二级预防用药情况（阿司匹林、氯吡格雷、硝酸酯类、曲美他嗪、尼可地尔、降压药、降糖药、降脂药）及不同生活方式（吸烟、饮酒、锻炼）下血压控制率的差异。结果：①手术方式对血压影响：CABG组男性收缩压及舒张压均低于PCI组及对照组，CABG组女性舒张压低于PCI组。②二级预防药物的使用情况：血压不达标组在曲美他嗪、利尿剂、钙拮抗剂、β受体阻滞剂、ACEI/ARB使用率上显著高于血压正常组。③生活方式情况：吸烟的冠心病患者血压达标率显著低于不吸烟的冠心病患者，是否饮酒及锻炼在血压达标率上没有表现显著差异。结论：冠心病患者血压控制仍不理想，CABG术较PCI术可能更有利于冠心病患者血压的控制，戒烟及提高冠心病二级预防药物的使用率仍是血压控制主要手段。

关键词: 冠心病, 高血压, PCI, CABG, 药物, 生活方式, 二级预防

Abstract: Objective: To evaluate the level of blood pressure control in patients with coronary heart disease (CHD) of China in order to provide guidance for the prevention and treatment of CHD.Methods: The patients with CHD were retrospectively collected from 2011~2014 in PLA General Hospital and Hainan Branch Hospital. Then analyzed the difference of blood pressure compliance rate between different surgical methods percutaneous coronary intervention (PCI), coronary artery bypass grafting(CABG), secondary preventive drugs(aspirin, clopidogrel, nitrates, trimetazidine, nicorandil, hypotensor, hypoglycemic, lipid-lowering drugs) and lifestyle(smoking, drinking, exercise).Results: ①Effects of surgical methods on blood pressure:Male's systolic blood pressure (SBP) and diastolic blood pressure(DBP) in the CABG group were lower in the PCI group and control group, and female's DBP in the CABG group were lower in the PCI group. ②Usage rate of secondary prevention drugs:usage rate of trimetazidine, calcium antagonist, β-blockers, angiotensin-converting enzyme inhibitor (ACEI) and angiotensin receptor antagonist (ARB) in hypertension group were higher than in normal blood pressure group. ③ Lifestyle condition:compliance rate of blood pressure in the smoking group was lower than that in the non smoking group. And there was no significant difference in blood pressure compliance rate among whether drinking and doing exercise or not.Conclusion: Blood pressure control in patients with CHD was still not satisfied. Compared with PCI, CABG may be more beneficial in the control of blood pressure in patients with CHD. Smoking cessation and improving the usage rate of secondary preventive drugs are still the main means of blood pressure control.

Key words: coronary heart disease, hypertension, PCI, CABG, drug, lifestyle, secondary prevention

张越, 王甜甜, 郭树理, 韩丽娜, 张丽, 李小鹰, 樊锦. 冠心病患者血压控制水平现况[J]. 中国应用生理学杂志, 2018, 34(1): 23-27.

ZHANG Yue, WANG Tian-tian, GUO Shu-li, HAN Li-na, ZHANG Li, LI Xiao-ying, FAN Jin. Current status of blood pressure control in patients with coronary heart disease[J]. CJAP, 2018, 34(1): 23-27.

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冠心病患者血压控制水平现况

Current status of blood pressure control in patients with coronary heart disease

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