动态心电图监测对原发性高血压患者室性心律失常风险的临床预测价值  

Clinical predictive value of holter monitoring for ventricular arrhythmias in patients with primary hypertension

作　　者：钱莉 汪品矜 周莹 QIAN Li;WANG Pin-jin;ZHOU Ying(Electrocardiography Room,Chizhou Hospital of Traditional Chinese Medicine,Chizhou Anhui 247000,China;Electrocardiography Room,Chizhou People's Hospital,Chizhou Anhui 247000,China)

机构地区：[1]池州市中医医院心电图室,安徽池州247000 [2]池州市人民医院心电图室,安徽池州247000

出　　处：《临床和实验医学杂志》2025年第5期549-553,共5页Journal of Clinical and Experimental Medicine

基　　金：安徽省卫生健康委科研项目(编号:AHWJ2021a006)。

摘　　要：目的观察原发性高血压(PH)患者动态心电图监测情况,并探究其对室性心律失常的预测价值。方法回顾性纳入2021年1月至2024年8月池州市中医医院收治的90例PH患者作为研究对象。所有PH患者均接受动态心电图检查,根据有无室性心律失常分组:其中30例出现室性心律失常患者设为发生组(最终入组28例),60例未出现室性心律失常患者设为未发生组(最终入组52例)。分析组间临床资料(性别、吸烟史、饮酒史、高血压、糖尿病、高脂血症、心率、年龄、收缩压、舒张压、甘油三酯、总胆固醇、肺动脉主干内径、右心室前后径、右心房横径、左心房舒张末期内径),并对组间动态心电图监测指标[P波离散度、Tp-e间期、总体标准差(SDNN)、RR间期平均值标准差(SDANN)、差值均方根(RMSSD)、相邻NN间期相差大于50 ms的个数占总心跳次数的百分比(PNN50)]进行分析;采用多因素Logistic回归分析影响PH患者室性心律失常发生的因素;采用受试者操作特征(ROC)曲线检验模型的预测效能。结果发生组和未发生组患者的性别构成比、吸烟史、饮酒史、高血压、舒张压、高脂血症、甘油三酯、总胆固醇、右心室前后径、左心房舒张末期内径差异均无统计学意义(P>0.05),发生组的糖尿病发生率、年龄、心率、收缩压、肺动脉主干内径、右心房横径均高于未发生组,差异均有统计学意义(P<0.05)。发生组患者的P波离散度、Tp-e间期分别为(42.88±8.12)、(112.56±12.02)ms,均高于未发生组[(36.11±7.12)、(99.13±12.46)ms],发生组患者的SDNN、SDANN、RMSSD、PNN50分别为105.12±9.12、88.46±10.12、24.58±4.15、5.26±0.46,均低于未发生组(122.12±10.12、93.15±12.02、33.46±5.15、14.33±0.78),差异均有统计学意义(P<0.05)。经单因素及多因素分析可知,糖尿病、年龄、心率、P波离散度、Tp-e间期、SDNN、SDANN、RMSSD、PNN50均会影响患者出现室性心�Objective To observe Holter monitoring in patients with primary hypertension(PH)and explore its predictive value for ventricular arrhythmia.Methods A total of 90 patients with PH admitted to Chizhou Hospital of Traditional Chinese Medicine from January 2021 to August 2024 were retrospectively included as the study subjects.All patients with PH underwent ambulatory electrocardiogram(ECG)examination.They were grouped according to the presence or absence of ventricular arrhythmia:among them,30 patients with ventricular arrhythmia were selected as the occurrence group(finally 28 cases were included in the group),and another 60 patients without ventricular arrhythmia were included in the non-occurrence group(finally 52 cases were included in the group).The clinical data(gender,smoking history,drinking history,hypertension,diabetes,hyperlipidemia,heart rate,age,systolic blood pressure,diastolic blood pressure,triglycerides,total cholesterol,pulmonary artery diameter,right ventricular diameter,right atrial diameter,left atrial end diastolic diameter)between the groups were analyzed,and the monitoring indicators of ambulatory ECG[P wave dispersion,Tp-e interval,standard deviation of the normal population(SDNN),sequential five-minute R-R interval means(SDANN),root mean square of successive differences(RMSSD),the percentage of the number of adjacent NN intervals greater than 50 ms in the total number of sinus beats(PNN50)]between the groups were analyzed.The factors affecting the occurrence of ventricular arrhythmia in patients with PH were analyzed by multivariate Logistic regression analysis.The predictive efficacy of the test model was analyzed using the receiver operating characteristic(ROC)curve.Results There were no statistically significant differences in gender composition ratio,smoking history,drinking history,hypertension,diastolic blood pressure,hyperlipidemia,triglyceride,total cholesterol,right ventricular anteroposterior diameter and left atrial end-diastolic diameter between the occurrence group and the non-

关 键 词：动态心电图 原发性高血压 室性心律失常 风险预测 

分 类 号：R541.4[医药卫生—心血管疾病]