高血压病患者脉压与心电图异常关系的探讨

Relationship between pulse pressure and electrocardioegram abnormality in essential hypertensive patients

目的研究脉压与心肌肥厚及心电图异常的关系。方法抽样调查60岁以上人群1243人并进行测血压和心电图检查,对其中739例高血压病患者进行分析。按平均压<113mmHg、≥113mmHg分为2组,再以脉压≤60mmHg、60～80mmHg、81～100mmHg、>100mmHg分为4个亚组。结果(1)随着脉压增加,心肌肥厚和心电图异常的发生率均逐渐增加(P<0.05或0.01)。(2)血糖、总胆醇、甘油三酯、高密度脂蛋白-胆固醇、低密度脂蛋白-胆固醇、体重指数并不随脉压增加而改变(P>0.05)。(3)脉压相同而平均压<113mmHg组心肌肥厚和心电图异常的发生率均无统计学意义(P>0.05),而平均压≥113mmHg组的收缩压、舒张压、平均压均高于平均压<113mmHg组(P<0.01)。结论高血压病患者脉压与心电图的相关性比收缩压、舒张压更为密切。

Objective To investigate the relationships between pulse pressure （PP）, myocardial hypertrophy and electrocardiogram （ECG） abnormality. Methods 1243 subjects ≥ 60 years were sampled to examine blood pressure and electrocardiogram. 739 patients with essential hypertension were selected and analyzed in this study. They were first divided into two groups by mean blood pressure （MBP） level （MBP 〈 113mmHg, MBP≥ 113mmHg）, then were divided into four subgroups by PP level （PP ≤60,61-80,81-100 and 〉 100mmHg）. Results （1） The prevalence of myocardial hypertrophy and ECG abnormality increased with increasing PP levels （P 〈 0.05）. （2） The levels of blood glucose, total cholesterol （TC）, triglyceride （TG）, high density lipoprotein-cholesterol （HDL-C）, low density lipoprotein-cholesterol （LDL-C） and body mass index （BMI） showed on relationship with PP （P 〉 0.05）. （3） In patients with the same PP level, no difference was found in the prevalence of myocardial hypertrophy and ECG abnormality between MBP 〈 113mmHg and MBP≥ 113mmHg （ P〉 0.05 ）. SBP and DBP levels were significantly higher in group with MBP≥ 113mmHg than group with MBP 〈 113mmHg （P〈 0.01）. Conclusion High PP was more related with ECG abnormality than SBP and DBP in essential hypertensive patients.