不同血压水平的高血压患者心脏电学改变研究  

Cardiac electrical changes in hypertensive patients with different blood pressure levels

作　　者：井艳[1] 张芳芳[1] 申继红[1] 闫琼文 周雨菡 黄菊香[1] 聂连涛 李中健[1] 李世锋[1] Jing Yan;Zhang Fangfang;Shen Jihong;Yan Qiongwen;Zhou Yuhan;Huang Juxiang;Nie Liantao;Li Zhongjian;Li Shifeng(Department of Electrocardiography,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450014,China)

机构地区：[1]郑州大学第二附属医院心电图科,郑州450014

出　　处：《中国实用医刊》2024年第8期13-17,共5页Chinese Journal of Practical Medicine

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20210392)。

摘　　要：目的探讨不同血压水平的高血压患者心脏电学改变特点。方法回顾性抽取2022年10月至2023年10月在郑州大学第二附属医院住院并行常规心电图、动态血压检查的高血压患者150例,经过降压治疗后,依据血压控制水平分为A、B、C、D、E 5个亚组,每组30例。其中A、B组为低水平血压组,C组为中水平血压组,D、E组为高水平血压组。观察和分析不同组间患者心电图改变特点。结果A、B、C、D、E 5个亚组心电图异常率均较高,分别为93.33%(28/30)、93.33%(28/30)、96.67%(29/30)、100.00%(30/30)、100.00%(30/30),主要表现为左心房/左心室肥大、心肌缺血(ST-T改变)和心律失常,其中缓慢性心律失常多于快速性心律失常,差异有统计学意义(P<0.05)。与中低水平血压组(A、B、C组)相比,高水平血压组(D、E组)左心房/左心室肥大发生率、左心房肥大定性指标(P波时限延长发生率)和定量指标(P波时限)较高(P<0.05)。与中水平血压组(C组)相比,高水平血压组(D、E组)和低水平血压组(A、B组)的定性指标(ST段压低发生率)和定量指标(Rv4高电压、T波倒置深度)相似,均较高(P<0.05)。结论不同血压水平的高血压患者心电图改变的主要表现均为左心房/左心室肥大、心肌缺血(ST-T改变)和心律失常,但具体表现有差异。Objective To investigate the characteristics of cardiac electrical changes in hypertensive patients with different blood pressure levels.Methods A total of 150 hypertensive patients treated in the Second Affiliated Hospital of Zhengzhou University from October 2022 to October 2023 who underwent routine electrocardiogram examination and ambulatory blood pressure monitoring were retrospectively selected.After antihypertensive treatment,the selected patients were divided into five subgroups(groups A,B,C,D,and E)according to the levels of blood pressure control,with 30 cases in each group.In addition,group A and group B belonged to the low-level blood pressure group;group C belonged to the moderate-level blood pressure group;while group D and group E belonged to the high-level blood pressure group.The characteristics of electrocardiogram changes of different groups were observed and analyzed.Results The rates of abnormal electrocardiogram in the five subgroups(groups A,B,C,D,and E)were 93.33%(28/30),93.33%(28/30),96.67%(29/30),100.00%(30/30),and 100.00%(30/30),respectively,all of which were higher.The main manifestations of abnormal electrocardiogram were left atrial/left ventricular hypertrophy,myocardial ischemia(ST-T changes),and arrhythmia.Among them,bradycardia was more common than tachycardia,with significant differences(P<0.05).Compared with the low-level and moderate-level blood pressure groups(groups A,B,and C),the high-level blood pressure groups(group D and E)had a higher incidence of left atrial/left ventricular hypertrophy,as well as higher qualitative indicator(incidence of P-wave prolongation)and higher quantitative indicator(P-wave duration)of left atrial hypertrophy,with statistical differences(P<0.05).The qualitative indicators(incidence of ST segment depression)and quantitative indicators(Rv4 high voltage,T-wave inversion depth)in the high-level blood pressure groups(group D and group E)and low-level blood pressure groups(group A and group B)were similar,all of which were higher than those in the m

关 键 词：高血压 血压状态 心脏电学 左房室肥大 心肌缺血 心律失常 

分 类 号：R544.1[医药卫生—心血管疾病]