心血管康复医学杂志
心血管康複醫學雜誌
심혈관강복의학잡지
JOURNAL OF CARDIOVASCULAR REHABILITATION MEDICINE
2014年
4期
439-442
,共4页
冠状动脉疾病%颈动脉疾病%心电描记术
冠狀動脈疾病%頸動脈疾病%心電描記術
관상동맥질병%경동맥질병%심전묘기술
Coronary artery disease%Carotid artery disease%Electrocardiography
目的：探讨冠心病患者颈动脉硬化（CAS）与异常心电图的关系及与血压的相关性。方法：收集冠心病患者389例，分为 CAS 组213例，无 CAS 组176例。比较两组患者的心电图异常情况，同时比较 CAS 组内不同程度CAS 患者间的心电图及血压情况。结果：与无 CAS 组比较，CAS 组的房颤、Ⅱ～Ⅲ度房室传导阻滞、ST 段压低总导联、异常 T 波总导联、ST 段偏移伴 T 波异常、心绞痛伴 ST 段压低的构成比例均显著增大（P ＜0.05～＜0.01）。随着 CAS 级别的增加（I 级～IV 级），房颤（8.33％比21.33％比31.03％比45.00％）、ST 段压低总导联数（17.64％比27.22％比37.07％比52.08％）、异常 T 波总导联数（5.00％比6.56％比10.34％比22.08％）、ST段偏移伴 T 波异常（26.67％比37.33％比50.00％比60.00％）的比例逐渐增加（P ＜0.05或＜0.01）。CAS 患者和无 CAS 患者的舒张压（DBP）无明显差异，CAS 患者的收缩压（SBP）、脉压（PP）明显高于无 CAS 患者，且随着 CAS 程度的增加而逐渐增加（P ＜0.05～＜0.01）。Pearson 相关分析显示，CAS 与 SBP、PP 呈明显正相关（r＝0.838、0.674，P 均＜0.01）。结论：伴颈动脉硬化的冠心病患者异常心电图的发生率较无颈动脉硬化冠心病患者的显著升高，且颈动脉硬化与收缩压、脉压呈正相关。因此，颈动脉硬化能较好地反映冠心病患者病情。
目的：探討冠心病患者頸動脈硬化（CAS）與異常心電圖的關繫及與血壓的相關性。方法：收集冠心病患者389例，分為 CAS 組213例，無 CAS 組176例。比較兩組患者的心電圖異常情況，同時比較 CAS 組內不同程度CAS 患者間的心電圖及血壓情況。結果：與無 CAS 組比較，CAS 組的房顫、Ⅱ～Ⅲ度房室傳導阻滯、ST 段壓低總導聯、異常 T 波總導聯、ST 段偏移伴 T 波異常、心絞痛伴 ST 段壓低的構成比例均顯著增大（P ＜0.05～＜0.01）。隨著 CAS 級彆的增加（I 級～IV 級），房顫（8.33％比21.33％比31.03％比45.00％）、ST 段壓低總導聯數（17.64％比27.22％比37.07％比52.08％）、異常 T 波總導聯數（5.00％比6.56％比10.34％比22.08％）、ST段偏移伴 T 波異常（26.67％比37.33％比50.00％比60.00％）的比例逐漸增加（P ＜0.05或＜0.01）。CAS 患者和無 CAS 患者的舒張壓（DBP）無明顯差異，CAS 患者的收縮壓（SBP）、脈壓（PP）明顯高于無 CAS 患者，且隨著 CAS 程度的增加而逐漸增加（P ＜0.05～＜0.01）。Pearson 相關分析顯示，CAS 與 SBP、PP 呈明顯正相關（r＝0.838、0.674，P 均＜0.01）。結論：伴頸動脈硬化的冠心病患者異常心電圖的髮生率較無頸動脈硬化冠心病患者的顯著升高，且頸動脈硬化與收縮壓、脈壓呈正相關。因此，頸動脈硬化能較好地反映冠心病患者病情。
목적：탐토관심병환자경동맥경화（CAS）여이상심전도적관계급여혈압적상관성。방법：수집관심병환자389례，분위 CAS 조213례，무 CAS 조176례。비교량조환자적심전도이상정황，동시비교 CAS 조내불동정도CAS 환자간적심전도급혈압정황。결과：여무 CAS 조비교，CAS 조적방전、Ⅱ～Ⅲ도방실전도조체、ST 단압저총도련、이상 T 파총도련、ST 단편이반 T 파이상、심교통반 ST 단압저적구성비례균현저증대（P ＜0.05～＜0.01）。수착 CAS 급별적증가（I 급～IV 급），방전（8.33％비21.33％비31.03％비45.00％）、ST 단압저총도련수（17.64％비27.22％비37.07％비52.08％）、이상 T 파총도련수（5.00％비6.56％비10.34％비22.08％）、ST단편이반 T 파이상（26.67％비37.33％비50.00％비60.00％）적비례축점증가（P ＜0.05혹＜0.01）。CAS 환자화무 CAS 환자적서장압（DBP）무명현차이，CAS 환자적수축압（SBP）、맥압（PP）명현고우무 CAS 환자，차수착 CAS 정도적증가이축점증가（P ＜0.05～＜0.01）。Pearson 상관분석현시，CAS 여 SBP、PP 정명현정상관（r＝0.838、0.674，P 균＜0.01）。결론：반경동맥경화적관심병환자이상심전도적발생솔교무경동맥경화관심병환자적현저승고，차경동맥경화여수축압、맥압정정상관。인차，경동맥경화능교호지반영관심병환자병정。
Objective:To explore the relationship between carotid atherosclerosis (CAS)detected by ultrasonography and ECG abnormality and correlation between CAS and blood pressure in patients with coronary heart disease (CHD).Methods:A total of 389 CHD patients were divided into CAS group (n=213)and no CAS group (n=176).ECG abnormalities were compared between two groups,and ECG and blood pressure were compared among patients with different degrees of CAS in CAS group.Results:Compared with no CAS group,there were significant rise in constituent ratios of atrial fibrillation,Ⅱ~Ⅲ°atrioventricular block,total lead number of ST segment de-pression,and of abnormal T wave,ST segment deviation complicated abnormal T wave and angina pectoris compli-cated ST segment depression in CAS group (P <0.05~<0.01).Along with CAS grade increased (grade I~ grade IV),there were gradual rise in percentages of atrial fibrillation (8.33% vs.21.33% vs.31.03% vs.45.00%),to-tal lead number of ST segment depression (17.64% vs.27.22% vs.37.07% vs.52.08%),total lead number of ab-normal T wave (5.00% vs.6.56% vs.10.34% vs.22.08%)and ST segment deviation complicated abnormal T wave (26.67% vs.37.33% vs.50.00% vs.60.00%),P <0.05 or <0.01. There were no significant difference in diastolic blood pressure (DBP)between no CAS group and CAS group,but systolic blood pressure (SBP)and pulse pressure (PP)of CAS patients were significantly higher than those of no CAS patients,and they gradually elevated along with CAS severity increased (P <0.05~<0.01).Pearson correlation analysis indicated that CAS was signifi-cant positively correlated with SBP and PP (r =2.064,1.348,P <0.01 both).Conclusion:The incidence rate of abnormal ECG in CHD patients complicated CAS is higher than that of CHD patients without CAS;and CAS is pos-itively correlated with blood pressure.Therefore,carotid ultrasonography can better reflect CHD patients′condition.
