胡润旋,姜昊言,王娟,陶静,赖红梅,余小林,郭自同,杨毅宁

• 1:新疆医科大学第一附属医院(第一临床医学院)心脏中心
• 2:新疆心脏血管稳态与再生医学研究重点实验室
• 3:新疆维吾尔自治区人民医院心内科
• 4:新疆大学生命科学与技术学院

摘要(Abstract)：

目的 探讨高血压对冠状动脉慢性完全闭塞（CTO）病变患者冠状动脉侧支循环（CCC）形成的影响。方法 回顾性纳入2021年10月至2023年12月在新疆医科大学第一附属医院和新疆维吾尔自治区人民医院10 205例接受冠状动脉造影的患者，经排除后最终入组602例CTO病变患者。根据Rentrop分级将患者分为CCC良好组329例（Rentrop 2～3级）与CCC不良组273例（Rentrop0～1级），比较两组基线特征，并通过多变量Logistic回归分析独立预测因素。结果 CCC不良组收缩压显著高于CCC良好组[（134.31±19.31）mmHg比（125.88±19.08）mmHg,P<0.001]，舒张压显著低于CCC良好组[（73.93±10.88）mmHg比（83.95±12.83）mmHg,P<0.001]。多因素分析显示，舒张压（OR 0.87,95%CI 0.86～0.90,P<0.001）和右冠状动脉闭塞（OR 0.57,95%CI0.38～0.85,P=0.006）是CCC的独立保护因素；收缩压（OR 1.05,95%CI 1.05～1.08,P<0.001）是CCC的独立危险因素。受试者工作特征（ROC）曲线分析提示舒张压截断值为79.5 mmHg[曲线下面积（AUC）=0.74，敏感度38.50%，特异度64.70%]。结论 收缩压水平与CTO病变患者CCC不良显著正相关，舒张压水平与CCC良好正相关。维持适当的舒张压（最好低于90 mmHg）可能有助于改善CCC，但需前瞻性研究进一步验证因果关系。

关键词(KeyWords)： 冠状动脉慢性完全闭塞;侧支循环;舒张压;高血压;Rentrop分级

Abstract:

Keywords:

基金项目(Foundation): “天山英才”医药卫生高层次人才培养计划项目(TSYC202401B021)

作者(Author): 胡润旋,姜昊言,王娟,陶静,赖红梅,余小林,郭自同,杨毅宁

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