青年原发性高血压病患者的临床及心电图特点分析  

The clinical and electrocardiogram characteristics of young adults with hypertension

作　　者：马一鸣[1] 韩菲[2] 赵丽[1] 郭亚涛[1] 郜玲[1] 王晋丽[1] 文冬凌[1] 石亚君[1] 卢喜烈[1] 单兆亮[1] 

机构地区：[1]解放军总医院心血管内科心脏无创检测中心,北京100853 [2]解放军316医院特检科

出　　处：《中华保健医学杂志》2016年第1期18-20,共3页Chinese Journal of Health Care and Medicine

摘　　要：目的探讨青年高血压病患者的临床特点。方法选择2013年1月1日至~2014年6月30日在本院心内科门诊就诊的青年原发性高血压病患者（〈45岁）157例,并选择同期健康查体青年311例作为对照组,分析患者临床及心电图特点。结果青年高血压组患者平均病史（5.2±3.6）年,按收缩压分级,1、2、3级高血压患者所占比例分别为37.8%、52.3%和4.8%,单纯舒张压升高占5.1%。高血压组患者无高血压相关症状者87例（29%）,有家族史者112例（71.3%）,超重患者80例（50.9%）,代谢综合征患者52例（33.1%）。与健康青年比较,青年高血压患者的体质量指数、腰围、血清糖化血红蛋白、尿酸、脑钠肽、室间隔/左室后壁厚度差异有统计学意义（P〈0.05）。82例（52.2%）患者有心电图ST-T改变,RV5、RV5＋SV1与对照组比较有显著性差异,平均心率、PR间期、P波时限、QT及QTc间期两组比较,差异无统计学意义。结论青年高血压患者多以无症状高血压和舒张压升高为特点,超重和代谢综合征患者较正常人群增多,心电图左心室高电压较正常人群增多。Objective To explore the clinical and electrocardiogram characteristics of young adults with hypertension.Methods We enrolled 157 young adults aged under 45 from 2013-1-1 to 2014-6-30 as hypertension group, and 311 healthy young adults as control group. The clinical and electrocardiogram characteristics of the young adults were analyzed. Results The mean persistent period of hypertension in these patients was 5.2 ± 3.6 years; the percentage of each grade of hypertension was 37.8%（Ⅰ）, 52.3%（Ⅱ）, and 4.8%（Ⅲ）, diastolic pressure hypertension（5.1%）; 29%（87/157） of patients were asymptomatic, 71.3% of patients had hypertension family history（112/157）, 50.9% of patients were overweigh（80/157）and 33.1% of patients were diagnosed with Metabolic Syndrome（52/157）; compared with healthy young adult, patients with hypertension had higher BMI, waist,glycosylated hemoglobin, uric acid, brain natriuretic peptide, and ventricular septum/posterior wall thickness ratio（P 〈 0.05）; we found ST-T changes in 82 patients in hypertension group, and their R_（V5） and R_（V5）＋ S_（V1） values were significantly higher than those in control group. Conclusion For young adults with hypertension, most of them manifested as asymptomatic hypertension and diastolic hypertension. There are more cases have overweight, metabolic syndrome, and left ventricle high voltage. More attention should be paid to patients＇ renal function and heart structure in the early stages of young adult hypertension.

关 键 词：青年高血压 超声心动图 心电图 胱抑素C 脑钠肽 

分 类 号：R544.1[医药卫生—心血管疾病]