114例原发性高血压患者晨醒前后动态心电图变化分析  

Dynamic electrocardiographic changs before and after morning waking in essential hypertensive patients

作　　者：吉顺利 史永莉 宋亿楠[2] 王一刚 Ji Shunli, Shi Yongli, Song Yi＇nan, et al. （ 1 The hospital for prevent and therapy psychiatry of Zhengzhou, Henan 450005 China ; 2Armed police hospital of Henan ）

机构地区：[1]郑州市精神病防治医院,河南郑州450005 [2]武警河南总队医院

出　　处：《中国保健》2008年第26期1250-1253,共4页Chinese Health Care

摘　　要：目的：探讨原发性高血压（EH）患者动态心电图（DCG）在晨醒前后的变化特点，为此类病人晨峰高血压时防控心血管事件的发生提供对策依据。方法：连续对确诊的EH患者114例进行DCG十二导联检测，据日志记录的晨醒时间，搜集晨醒前后各3h的DCG资料，按晨醒前与晨醒后分组，和按性别、年龄、高血压各期再分亚组比较。结果：①晨醒后EH患者心率（HR），短阵性ST（V5）缺血性下移的发生率与下移的幅度都增加，室性早搏较多（均P〈0．01）；②晨醒后各亚组HR和短阵性ST（V5）缺血性下移幅度均较显著（P〈0．01），晨醒后短阵性ST（V5）缺血性下移幅度还见于老年组比中青年组为著，高血压2期比1期明显（P〈0．05—0．01）；⑧晨醒后存有短阵ST（V5）缺血性下移患者同时伴发有心悸、胸闷、头晕和心前区痛等症状的较多，伴发有房性早搏、短阵性房扑与房颤等心率失常者亦较多（均P〈0．01）。结论：EH患者晨醒后DCG异常改变较显著。Objective：To make a survey analysis of the changed before and aften morning waking of dynamic electrocardiogram （DCG）in patients with essential hypertensive（EH）, Methods： DCG study were performed on 114 consecutive patients with proven EH,in the present study were abtained changes in DCG monitoring 24 hours, each patient recorded his owen daily activeties. To maked data of before and aften morning waking 3 hours were divided into two groups, again with different ages,sexes and hypertensive class period divided into sub- groups were comparative analysed. Results： （1）Morning post - awakening heart rate （HR） , incidence and amplitudes of brevity ST （ V5 ） ischaemia displacement, ventricular premature contraction in patients with EH were increased than that in its morning pre - awakening（ all P 〈 0. 01 ）. （2）Compared with morning pre - waking several sub - groups patients, HR and brzevety ST（ V5 ） segment ischaemia displacement amplitude in morning post - awakening several sub - groups patients were increased;again frzevity ST（ V5 ）segment ischaemia displacement amplitude in morning post - awakening elder than middle young - age, hypertensive 2 period than 1 period were increased（ P 〈 0. 05 - 0. 01 ）. （3）In patients morning post - awakening with brevity ST（ V5 ） segment ischaemia displacement amplitude, concomitant with the palpitation, chest discormfort, digginess and pracordialgia pain, etc symptoms, and with atrial premature contraction, brevity atrial flutter and atrial fibrillation, etc arrhythmias increased, respectively（ P 〈 0. 01 ）. Conclusion：The data show that are marked DCG abnormality changes morning pre - awakening than morning post - awakening in EH patients.

关 键 词：原发性高血压 动态心电图 心肌缺血 室性早搏 

分 类 号：R540.411[医药卫生—心血管疾病;医药卫生—临床医学;医药卫生—内科学]