中华全科医师杂志
中華全科醫師雜誌
중화전과의사잡지
CHINESE JOURNAL OF GENERAL PRACTITIONERS
2011年
2期
97-100
,共4页
李萍%李俭春%周国宝%孙康云
李萍%李儉春%週國寶%孫康雲
리평%리검춘%주국보%손강운
高血压%血压%心律失常%心肌缺血
高血壓%血壓%心律失常%心肌缺血
고혈압%혈압%심률실상%심기결혈
Hypertension%Blood pressure%Arrhythmia%Myocardial ischemia
目的 探讨原发性高血压患者血压晨峰对心脏重构以及心血管事件的影响.方法 2006年2月至2009年1月在本院就诊的高血压病患者中,按就诊顺序连续入选386例高血压患者,根据动态血压检测结果,分为晨峰组(146例)和非晨峰组(240例),均同步记录24 h动态血压和动态心电图,观察24 h动态血压参数,24 h动态心电图检出的房性、室性心律失常及ST段偏移;行超声心动图检测左室质量指数(LVMI)、左房内径等指标.结果 晨峰组与非晨峰组LVMI分别为(119±21)g/m2和(93±12)g/m2(P＜0.01);左房内径分别为(46±11)mm与(38±10)mm(P＜0.05);房性早搏检出率分别为9 8.6%与84.2%(P＜0.05);房性心动过速检出率分别为54.1%与20.8%(P＜0.01);心房颤动检出率分别为24.0%与0(P＜0.01);室性早搏和室性心动过速的检出率分别为79.5%与57.9%(P＜0.05)和6.8%与2.5%(P＜0.05);检出ST段水平型压低率分别为33.6%与13.8%(P＜0.01).两组左室肥厚的检出率分别为67.1%与30.4%(P＜0.01).53.2%的心律失常和57.6%的ST段压低发作出现在清晨6:00～8:00.相关分析表明,清晨血压和血压晨峰升高与对应时域ST段压低呈正相关.结论 与无血压晨峰的高血压病患者相比,具有血压晨峰的高血压患者左心室肥厚更显著,心律失常和心肌缺血更常见,且多出现在清晨.
目的 探討原髮性高血壓患者血壓晨峰對心髒重構以及心血管事件的影響.方法 2006年2月至2009年1月在本院就診的高血壓病患者中,按就診順序連續入選386例高血壓患者,根據動態血壓檢測結果,分為晨峰組(146例)和非晨峰組(240例),均同步記錄24 h動態血壓和動態心電圖,觀察24 h動態血壓參數,24 h動態心電圖檢齣的房性、室性心律失常及ST段偏移;行超聲心動圖檢測左室質量指數(LVMI)、左房內徑等指標.結果 晨峰組與非晨峰組LVMI分彆為(119±21)g/m2和(93±12)g/m2(P＜0.01);左房內徑分彆為(46±11)mm與(38±10)mm(P＜0.05);房性早搏檢齣率分彆為9 8.6%與84.2%(P＜0.05);房性心動過速檢齣率分彆為54.1%與20.8%(P＜0.01);心房顫動檢齣率分彆為24.0%與0(P＜0.01);室性早搏和室性心動過速的檢齣率分彆為79.5%與57.9%(P＜0.05)和6.8%與2.5%(P＜0.05);檢齣ST段水平型壓低率分彆為33.6%與13.8%(P＜0.01).兩組左室肥厚的檢齣率分彆為67.1%與30.4%(P＜0.01).53.2%的心律失常和57.6%的ST段壓低髮作齣現在清晨6:00～8:00.相關分析錶明,清晨血壓和血壓晨峰升高與對應時域ST段壓低呈正相關.結論 與無血壓晨峰的高血壓病患者相比,具有血壓晨峰的高血壓患者左心室肥厚更顯著,心律失常和心肌缺血更常見,且多齣現在清晨.
목적 탐토원발성고혈압환자혈압신봉대심장중구이급심혈관사건적영향.방법 2006년2월지2009년1월재본원취진적고혈압병환자중,안취진순서련속입선386례고혈압환자,근거동태혈압검측결과,분위신봉조(146례)화비신봉조(240례),균동보기록24 h동태혈압화동태심전도,관찰24 h동태혈압삼수,24 h동태심전도검출적방성、실성심률실상급ST단편이;행초성심동도검측좌실질량지수(LVMI)、좌방내경등지표.결과 신봉조여비신봉조LVMI분별위(119±21)g/m2화(93±12)g/m2(P＜0.01);좌방내경분별위(46±11)mm여(38±10)mm(P＜0.05);방성조박검출솔분별위9 8.6%여84.2%(P＜0.05);방성심동과속검출솔분별위54.1%여20.8%(P＜0.01);심방전동검출솔분별위24.0%여0(P＜0.01);실성조박화실성심동과속적검출솔분별위79.5%여57.9%(P＜0.05)화6.8%여2.5%(P＜0.05);검출ST단수평형압저솔분별위33.6%여13.8%(P＜0.01).량조좌실비후적검출솔분별위67.1%여30.4%(P＜0.01).53.2%적심률실상화57.6%적ST단압저발작출현재청신6:00～8:00.상관분석표명,청신혈압화혈압신봉승고여대응시역ST단압저정정상관.결론 여무혈압신봉적고혈압병환자상비,구유혈압신봉적고혈압환자좌심실비후경현저,심률실상화심기결혈경상견,차다출현재청신.
Objective To investigate effects of morning blood pressure surge (MBPS) on cardiac remodeling and cardiovascular events in patients with essential hypertension.Methods Totally,386 patients with essential hypertension were recruited into the study,146 with MBPS and 240 without it based on their dynamic blood pressure monitoring.All the patients were monitored by 24-hour ambulatory blood pressure measurements,24-hour Holter electrocardiography and echocardiography for dynamic blood pressure,left ventricular mass index (LVMI),left atrial dimension (LAD),atrial and ventricular arrhythmias and ST depression,and so on.Results Compared with non-MBPS group,patients with MBPS had significantly higher incidence of left ventricular hypertrophy (LVH),enlargement of left atrial dimension,cardiac arrhythmias and myocardial ischemia detected,with LVMI [( 119 ±21 ) g/m2 vs.(93 ±12) g/m2,P＜0.01],LAD [(46±11) mmvs.(38±10) mm,P＜0.05],LVH (67.1% vs.30.4%,P ＜0.01 ),atrial premature beats (98.6% vs.84.2%,P ＜ 0.05 ),atrial tachycardia ( 54.1% vs.20.8%,P ＜ 0.01 ),atrial fibrillations ( 24.0% vs.0,P ＜ 0.0l ); ventricular premature beats and ventricular tachycardia ( 79.5% vs.57.9%,P ＜ 0.05,and 6.8% vs.2.5%,P ＜ 0.05 ),ST-segment depression (33.6% vs.13.8%,P ＜ 0.01 ),respectively.And,53.2 percent of cardiac arrhythmia and 57.6 percent of ST-segment depression occurred at six to eight o'clock in the morning.Blood pressure early in the morning and MBPS associated with ST-segment depression at the corresponding time ( P ＜ 0.05 ).Conclusions LVH is more significant,cardiac arrhythmias is severer and myocardial ischemia is more common in hypertensive patients with MBPS than that in those of non-MBPS.
