高血压患者血压波动与ST段降低的关系  

Blood Pressure Fluctuation and STSegment Depression in Essential Hypertension

作　　者：崔跃[1] 杜红光[1] 王雅滨[1] 

机构地区：[1]成都铁路局中心医院

出　　处：《高血压杂志》1997年第4期294-296,共3页Chinese Journal of Hypertension

摘　　要：评价２４ｈＳＴ段压低与血压波动的关系。方法１０７例患者进行２４ｈ动态血压检测并同时记录心电图，所有患者进行心血管危险度评价。结果以有无ＳＴ段降低进行分组（ＳＴ段降低＞１ｍｍ，＞６０ｓ）。２８例发现总共１３９段ＳＴ段压低，持续时间１５３±７５ｓ，压低幅度为１．４０±０．３５ｍｍ。在ＳＴ段降低时，收缩压升高１１±３ｍｍＨｇ，舒张压升高９±４ｍｍＨｇ，但ＳＴ段降低与心率快慢无明确相关。２４ｈ分布显示两个发病高峰，清晨及傍晚。平均动态血压负荷在ＳＴ段降低组高于ＳＴ段正常组，两组平均收缩压及舒张压ＳＴ段异常组高于ＳＴ段正常组（Ｐ＜０．０５），而白昼及夜间的平均血压亦为ＳＴ段异常组高于ＳＴ段正常组（Ｐ＜０．０１～０．０５）。两组间在临床特征、吸烟、饮酒等心血管危险因素方面无显著性差异，在高血压病程、血糖水平、血总胆固醇水平、左室重量指数等方面存在差异。结论高血压伴有ＳＴ段降低患者动态血压负荷高于无ＳＴ段降低患者，且两组患者在高血压病程、血糖、血脂水平、左室重量指数等方面存在差异。当ＳＴ段降低时，９２％血压伴随增高。ＳＴ段与心率的相关性还有待进一步研究。Aim To asses the prevalence and circadian distribution of STsegment depression n related to concomitant blood pressure(BP) fluctuation.\ Methods\ 107 patients underwent ambulatory blood pressure monitoring(ABPM) and Holter electrocardiogram simultaneously.\ Results\ 28 patients had a total 139 episodes of STsegment depression.\ Duration of such episodes was 153±75 seconds and amplitude was 140±035 mm.\ During ST depression episodes,systolic BP increased by 11±3 mmHg,diastolic BP by 9±4 mmHg.\ There were no clear relationship between STsegment depression and HR variation.\ Circadian distribution showed 2 peaks:on awakening and in the late afternoon.\ The mean ambulatory BP load and day or night mean blood pressure were greater in the patients with than without STsegment depression for both systolic and diatolic BP(P<005).\ Plasma glucose,Plasma total cholesterol,left ventricular mass index were also higher in patients with STsegment depression.\ No signifcant differences in clinical parameters,and cardiovascular risk factors between groups.\ Conclusion\ The ambulaory BP load was greater in the patients with than without STsegment depression in hypertension.\ During STsegment depression,the level of BP increased.

关 键 词：高血压 动态血压 ST段降低 心电图 

分 类 号：R544.102[医药卫生—心血管疾病]