收稿日期: 2026-01-28
网络出版日期: 2026-06-15
基金资助
甘肃省自然科学基金项目(21JR1RA168);“萃英科技创新”计划项目(CY2023-MS-B02);“萃英学子科研培育计划”项目(CYXZ2023-40);甘肃省卫生行业项目(GSWSKY2020-25)
Clinical correlation analysis of blood pressure circadian rhythm and coronary slow flow phenomenon
Received date: 2026-01-28
Online published: 2026-06-15
目的 探讨不同血压昼夜节律模式的临床特征，确定与正常杓型模式相比，特定的异常模式是否与发生CSFP的风险增加相关，并探究血压昼夜节律、夜间血压下降率与冠状动脉慢血流之间的相关性。 方法 共纳入2019—2024年间因“胸闷、胸痛”症状在兰州大学第二医院心内科接受冠状动脉造影（CAG）且无显著狭窄（狭窄程度≤ 40%）的275例患者，其中包括高血压患者、冠状动脉慢血流（CSFP）患者及高血压合并CSFP的患者。根据夜间血压下降率，将所有患者分为4组：杓型组、反杓型组、非杓型组和超杓型组。收集一般临床资料、冠状动脉造影结果和动态血压监测（ABPM）数据，并比较24 h、日间和夜间平均血压（BP）、晨峰血压及夜间血压下降率。采用线性相关分析和线性回归分析探讨CSFP与夜间血压下降率的相关性。 结果 相关分析结果显示，校正TIMI帧数（cTFC）与夜间SBP下降率（r = -0.186，P < 0.001）、DBP下降率（r = -0.206，P < 0.001）均呈显著负相关。多元线性回归分析证实，夜间血压下降率是CSFP的独立影响因素（P < 0.05），在调整了性别、年龄、体质量指数、吸烟、合并糖尿病、合并脑梗死等混杂因素后，相关性依然显著。 结论 收缩压和舒张压的夜间血压下降率均与冠状动脉慢血流现象独立相关，对高血压患者进行动态血压监测可能有助于监测CSFP。
狄晓凡 , 张克梵 , 张芳菁 , 张永 , 李明泽 , 王琼英 . 血压昼夜节律与冠状动脉慢血流现象的临床相关性分析[J]. 实用医学杂志, 2026 , 42(11) : 1923 -1932 . DOI: 10.3969/j.issn.1006-5725.2026.11.005
Objective This study was aimed at investigating the clinical characteristics of diverse blood pressure circadian rhythms and exploring the correlation among blood pressure circadian rhythm， nocturnal blood pressure decline rate， and coronary slow flow phenomenon （CSFP）. Methods A total of 275 patients who presented with chest tightness or chest pain and underwent coronary angiography （CAG） showing no significant stenosis （≤ 40%） at the Department of Cardiology， the Second Hospital of Lanzhou University from 2019 to 2024 were included in the study. The cohort was composed of hypertensive patients， CSFP patients， and patients with both conditions. According to the nocturnal blood pressure decline rate， all patients were classified into four groups： dipper， reverse-dipper， non-dipper， and extreme-dipper. General clinical data， CAG findings， and ambulatory blood pressure monitoring （ABPM） data were collected. Comparisons were carried out on the 24-hour， daytime， and nighttime mean blood pressure （BP）， morning BP surge， and nocturnal BP decline rate. Linear correlation analysis and linear regression analysis were employed to investigate the correlation between CSFP and the nocturnal BP decline rate. Results Correlation analysis indicated that the corrected TIMI frame count （cTFC） was significantly and negatively correlated with the nocturnal systolic blood pressure （SBP） decline rate （r = -0.186， P < 0.001） and the diastolic blood pressure （DBP） decline rate （r = -0.206， P < 0.001）. Multiple linear regression analysis verified that the nocturnal BP decline rate was an independent influencing factor for CSFP （P < 0.05）， and this correlation remained significant after adjusting for confounding factors such as gender， age， body mass index， smoking， diabetes， and cerebral infarction. Conclusions Both the decline rates of systolic and diastolic nocturnal blood pressure are independently correlated with the coronary slow flow phenomenon. Ambulatory blood pressure monitoring in hypertensive patients can assist in the detection of CSFP.
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