原发性高血压左心室肥厚患者心电图QRS波振幅参数与血压及左心室肥厚的相关性  

Correlation between ECG QRS amplitude parameters,and blood pressure and left ventricular hypertrophy in essential hypertensives with left ventricular hypertrophy

作　　者：黄慕坚 林玉涓 陈东明[2] 梁华静 林雨芳 刘靖 HUANG Mujian;LIN Yujuan;CHEN Dongming;LIANG Huajing;LIN Yufang;LIU Jing(Department of Electrocardiogram,Jiangmen City Wuyi Hospital of Traditional Chinese Medicine,Jiangmen Guangdong 529000;Graduate School,Southern Medical University,Guangzhou Guangdong 510300,China)

机构地区：[1]江门市五邑中医院心电图室,广东江门529000 [2]南方医科大学研究生院,广东广州510300

出　　处：《实用心电学杂志》2022年第6期429-433,共5页Journal of Practical Electrocardiology

基　　金：广东省医学科研基金立项项目(B2020415)。

摘　　要：目的探究原发性高血压左心室肥厚(essential hypertension with left ventricular hypertrophy,EH-LVH)患者心电图QRS波振幅参数与血压及左心室肥厚(left ventricular hypertrophy,LVH)的相关性。方法选取126例EH-LVH患者作为研究对象,根据LVH程度分为轻度组(n=51)、中度组(n=47)、重度组(n=28)。比较3组的血压、LVH指标[左心室后壁厚度(left ventricular posterior wall thickness,LVPWT)、室间隔厚度(interventricular septal thickness,IVST)、左心室质量指数(left ventricular mass index,LVMI)]、心电图QRS波振幅参数[S_(V_(1))+R_(V_(5))振幅、所有导联QRS波群振幅之和(12ΣQRSWA)、R_(Ⅰ)+S_(Ⅲ)振幅];分析QRS波振幅参数与血压、LVH指标的相关性及其与LVH程度的关系。结果重度组收缩压、舒张压明显高于轻度组、中度组,且中度组亦显著高于轻度组(P均<0.05);重度组LVPWT、IVST、LVMI值明显高于轻度组、中度组,且中度组亦明显高于轻度组(P均<0.05);重度组R_(Ⅰ)+S_(Ⅲ)振幅、12ΣQRSWA、S_(V_(1))+R_(V_(5))振幅显著小于轻度组、中度组,且中度组亦明显小于轻度组(P均<0.05)。Pearson相关性分析显示,R_(Ⅰ)+S_(Ⅲ)振幅、12ΣQRSWA、S_(V_(1))+R_(V_(5))振幅与舒张压、收缩压、LVPWT、IVST、LVMI均呈负相关(P均<0.05);R_(Ⅰ)+S_(Ⅲ)振幅、12ΣQRSWA、S_(V_(1))+R_(V_(5))振幅均与LVH程度有关(P均<0.05)。结论EH-LVH患者心电图QRS波群存在明显异常,表现为R_(Ⅰ)+S_(Ⅲ)振幅、12ΣQRSWA、S_(V_(1))+R_(V_(5))振幅降低,且与血压、LVH指标密切相关。通过测定心电图QRS波群,可评估EH-LVH患者的LVH程度。Objective To explore the correlation between ECG QRS amplitude parameters,and blood pressure and left ventricular hypertrophy(LVH)in patients with essential hypertension with left ventricular hypertrophy(EH-LVH).Methods A total of 126 patients with EH-LVH were enrolled as research objects.They were divided into mild group(n=51),moderate group(n=47)and severe group(n=28)according to the degree of LVH.We compared the blood pressure,LVH indexes[left ventricular posterior wall thickness(LVPWT),interventricular septal thickness(IVST)and left ventricular mass index(LVMI)],and ECG QRS amplitude parameters[S_(V_(1))+R_(V_(5)) amplitude,the sum of QRS amplitudes of all leads(12ΣQRSWA),R_(Ⅰ)+S_(Ⅲ)amplitude]among the three groups.The correlation between QRS amplitude parameters,and blood pressure and LVH indexes was analyzed while the relationship between QRS amplitude parameters and the degree of LVH was also analyzed.Results Systolic blood pressure(SBP)and diastolic blood pressure(DBP)in the severe group are significantly higher than those in the mild and moderate groups while these parameters in the moderate group are also significantly higher than those in the mild group(P<0.05).The LVPWT,IVST and LVMI values of the severe group are significantly higher than those of the mild and moderate groups while the above indexes of the moderate group are also significantly higher than those of the mild group(P<0.05).The R_(Ⅰ)+S_(Ⅲ)amplitude,12ΣQRSWA and S_(V_(1))+R_(V_(5)) amplitude in the severe group are all significantly lower than those in the mild and moderate groups while these amplitudes of the moderate group are also significantly lower than those in the mild group(P<0.05).Pearson correlation analysis shows that the R_(Ⅰ)+S_(Ⅲ)amplitude,12ΣQRSWA and S_(V_(1))+R_(V_(5)) amplitude are all negatively correlated with DBP,SBP,LVPWT,IVST and LVMI(P<0.05).The R_(Ⅰ)+S_(Ⅲ) amplitude,12ΣQRSWA and S_(V_(1))+R_(V_(5)) amplitude are all correlated with the degree of LVH(P<0.05).Conclusion The QRS complex in ECGs of

关 键 词：QRS波 振幅 高血压左心室肥厚 血压 左心室肥厚 

分 类 号：R544.1[医药卫生—心血管疾病] R540.4[医药卫生—内科学]