心电图和超声心动图诊断左室肥厚对高血压病患者预后的预测作用  

Electrocardiographic and Echocardiographic Diagnoses of Left Ventricular Hypertrophy and Their Predictability for Risk in Patients With Hypertension

作　　者：陈志群[1] 薛建设[1] 马建芳[1] 陈宏[1] 邱凤英[1] 

机构地区：[1]解放军第476医院内三科,福建福州350002

出　　处：《实用临床医学（江西）》2002年第2期35-37,共3页Practical Clinical Medicine

摘　　要：目的 :探讨老年高血压病患者心电图和超声心动图诊断左室肥厚 (LVH)与预测心血管事件危险性的关系。方法 :对 5 8例患者进行心电图和超声心动图随访 3～ 5年 ,平均 3 .9年 ,并测定血糖、血脂及C 反应蛋白等其他相关危险因素。结果 :在随访期间 ,发生心血管事件 3 5例 ( 89.74 % ) ,超声心动图LVH测定的敏感性 /特异性 ( % ) :3 9例LVH患者 2 3例 ( 5 8.79% ) (SV1+RV5或RV6)≥ 3 .5mv ,2 0例 ( 5 1.2 8% ) (SV3 +RaVL)≥ 2 .8mv ,2 4例( 61.5 3 % ) [(SV3 +RaVL)×QRS间期 ]>2 4 4 μV·S ,3 5例 ( 89.74 % )V4～V5导联中ST段压低 >0 .1mv ,伴T波低平或倒置。 5 8例随访前后血压变化有显著意义 (P <0 .0 5 )。C 反应蛋白及血糖变化无显著意义 (P >0 .0 5 )。LVM/m明显下降 (P <0 .0 5 )。结论 :左室肥厚的老年患者心血管危险性明显增加 。Objective:To evaluate the effects of electrocardiograph and echocardiography in dingnoses of left ventricular hypertrophy(LVH) and in prediction of risk in patients with hypertension. Methods: Electrocardiograph and echocardiography were performed in 58 patients with hypertension and left ventricular hypertrophy. The patients were followed up for 3 to 5 years. Results: During followed up, 35 (89.74%) patients underwent cardiovascular events. Echocardiographic Sensitivities/specifities (%) were 23/39 (58.79%). There were 20/39 (51.28%) showing SV1+RV5 or (RV6)≥3.5 mv; 24/39 (61.53%), (SV3+RavL)≥ 2.8 mv; 35/39 (89.74%),SV3+RaVL)×QRS duration>244 μV·S and ST segment depression>0.1 mv with T wave flattening or inversion in leads V4～V5 for left ventricular strain.During followed up, the hypertension of 58 patients was improved( P <0.01).CRP levels, however, were not changed( P >0.05). LVM/m reduced( P <0.05).The fasting glucose levels of 58 patients were 5.5±0.9 poml/L to 6.1 ±1.3 mmol/L( P <0.01).Conclusion:The patients with LVH resulted from hypertension would experience more cardiovascular events.There is difference of diagnostic significance between electrocardiograph and echocardiography in prediction of cardiovascular risk for the patient with hypwertension.

关 键 词：诊断 预后 预测 心电图 超声心动图 左室肥厚 高血压病 LVH 

分 类 号：R544.1[医药卫生—心血管疾病] R540.[医药卫生—内科学]