原发性高血压患者的血压与心电图变化的分析探讨

Blood Pressure and Electrocardiogram Analysis in Essential Hypertensive Patients

目的 对原发性高血压患者采用心电图明尼苏达编码的方法 ,分析城市高血压患者血压与心电图变化规律 ,为高血压伴心脏损害的患者提供心电图诊断的依据及临床相关信息。方法 对上海南市区 344 5名 35岁以上的确诊的原发性高血压患者进行血压 ,心率 ,体重指数 ,血脂的测定 ,同时进行心电图的检查 ,心电图采用明尼苏达编码的方法进行统计分析 ,对编码中的主要异常和次要异常指标与血压 ,血脂进行相关比较。结果 (1)城市社区中有 93.1%的高血压患者 ,血压未控制到正常血压范围水平。在病人中约有三分之一的高血压患者有心电图编码的异常 ,编码异常率为 30 97%。主要异常编码率 14 .2 8% ,次要编码频率 16 .6 9% ;(2 )高血压患者中异常编码的主要类型为T波改变及ST段的压低 ,有 2 %的患者出现Q波改变 ,心律失常的发生率 4 .5 % ;(3)随着高血压患者年龄的增加 ,异常编码率明显增高 ,在 >6 5岁老年患者中异常编码的心律失常 (房颤 )为多见 ;(4)在相关因素分析中发现收缩压和脉压与心电图的异常明显相关。结论 在高血压人群中 ,心电图的主要异常编码率较高 ,收缩压和脉压水平与异常编码有关 ,以T波改变和ST段压低多见。随着年龄的增长及收缩压的升高 ,异常心电图编码率明显增高。因此应重视对高血压水平的?

Objective\ Using Minnesota code to analyse the characteristics of blood pressure and ECG changes in urban hypertensive patients and offer the electrocardiographic diagnostic evidence and clinical information of cardiac injury.\ Methods\ Blood pressure,heart rate,body mass index,serum level of lipid and ECG were determined at the mean time in 3445 Shanghai hypertensive patients(35years and older).Statistical treatment were carried out for ECG data by means of Minnesota code and the correlation analysis were performed between the abnormal codes (major abnormalities and minor abnormalities) and blood pressure or lipid level.\ Results\ (1)The blood pressure level in 93.1% urban hypertensive patients were beyond the normal range. One third of all patients had abnormal codes,which frequency was 30 97% (the major abnormalities 14.28% and the minor 16.69%).\ (2)T wave changes and ST segment depression were the most common abnormalities.\ Pathologic Q wave and arrhythmia codes occurred only in 2% and in 4.5% respectively.\ (3)Most abnormalities were found to be positively related with age.Arrhythmia were quite prevalent in patients older than 65,especially atrial fibrillation.\ (4)Systolic blood pressure and pulse pressure showed obviously positive correlation with ECG abnormalities.\ Conclusion\ Hypertensive patients had a relatively higher rate of abnormal codes in ECG, in which ST-T changes were the most common. With the increase of systolic pressure ,pulse pressure and the older of the age , the abnormalities in ECG increased. So it is important to control blood pressure so as to prevent the cardiac damage.