原发性高血压患者动态心电图及动态血压的特点及其与左心室肥大的关系  

Characteristics of ambulatory electrocardiogram and ambulatory blood pressure in patients with essential hypertension and their relationship with left ventricular hypertrophy

作　　者：王志娟[1] 张丽君 耿海波 Wang Zhijuan;Zhang Lijun;Geng Haibo(ECG Room,Department of Functional Examination,Xinxiang First People’s Hospital,Xinxiang 453000,China)

机构地区：[1]河南省新乡市第一人民医院功检科心电图室,453000

出　　处：《中国实用医刊》2021年第16期40-43,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨原发性高血压患者动态心电图及动态血压的特点及其与左心室肥大的关系。方法抽取2018年6月至2020年9月于新乡市第一人民医院接受治疗的高血压致左心室肥厚(LVH)患者50例,计为LVH组;抽取同时期高血压不伴左心室肥厚(NLVH)患者47例,招募健康志愿者55例作为对照,计为健康组。三组人员均进行动态心电图、动态血压检查,计算并对比相应指标与LVH的相关性。结果 LVH组患者的动态血压参数24 h平均收缩压(24hmSBP)、24 h收缩压变异系数(24hSSD)以及日间收缩压变异系数(dSSD)均高于NLVH组(P<0.05),且经Pearson相关性分析均呈正相关关系(r=0.441、P<0.001;r=0.510、P<0.001;r=0.507、P=0.009);LVH组患者的动态心电图参数心前区和肢体导联最深S振幅(SD)、SD+V4导联S振幅(SD+SV4)均大于NLVH组,相关性分析显示为正相关关系(r=0.628、P<0.001;r=0.201,P=0.032);LVH组心电图异常总发生率高于对照组(P<0.05)。结论 LVH患者的24hmSBP、24hSSD、dSSD、SD、SD+SV4均高于NLVH患者,动态心电图和动态血压参数对原发性高血压患者是否合并有左心室肥大具有较高的诊断价值。Objective To investigate the clinical characteristics of dynamic electrocardiogram and ambulatory blood pressure in patients with essential hypertension and their correlation with left ventricular hypertrophy.Methods Fifty patients with left ventricular hypertrophy(LVH)who were treated in Xinxiang First People’s Hospital from June 2018 to September 2020 were selected as LVH group;forty-seven patients with non-left ventricular hypertrophy(NLVH)and 55 healthy volunteers were selected as control group.All of them received dynamic electrocardiogram and ambulatory blood pressure monitoring,and their correlation with LVH was analyzed.Results The 24-hour mean systolic blood pressure(24hmSBP),24-hour systolic blood pressure standard deviation(24hSSD),and daytime systolic blood pressure standard deviation(dSSD)in LVH group were higher than those in NLVH group(P<0.05).Pearson correlation analysis showed positive correlations(r=0.441,P<0.001;r=0.510,P<0.001;r=0.507,P=0.009).The deepest S amplitudes(SD)of precordial zone and limb leads,SD+V4 lead S amplitude(SD+SV4)in LVH group were greater than those in NLVH group,and correlation analysis showed a positive correlation(r=0.628,P<0.001;r=0.201,P=0.032).The total incidence of abnormal electrocardiogram in LVH group was higher than that in NLVH group(P<0.05).Conclusions The 24hmSBP,24hSDD,DSDD,SD,SD+SV4 of LVH patients were higher than those of NLVH patients.Ambulatory electrocardiogram and ambulatory blood pressure parameters have high diagnostic value for whether patients with essential hypertension have left ventricular hypertrophy.

关 键 词：原发性高血压 左心室肥大 动态心电图 动态血压 

分 类 号：R544.11[医药卫生—心血管疾病]