高血压病患者颈动脉斑块形成与动态心电图缺血性改变的相关性研究

The correlation between the formation of carotid plaques and the ischemic changes of Holter in hypertensive patients

目的:探讨高血压病患者颈动脉斑块形成与动态心电图缺血性改变之间的相关性。方法:把64例进行了冠脉CTA检查并且冠脉CTA检查排除冠脉病的高血压患者按照有无心电图缺血性改变分成2组。通过卡方检验及二项分类logistic回归分析筛选动态心电图缺血性改变的影响因素,并比较两组患者年龄、血脂、颈动脉IMT、颈动脉斑块积分以及斑块指数的差别,再建立颈动脉IMT、颈动脉斑块积分的ROC曲线,评估颈动脉IMT、颈动脉斑块积分对心电图缺血性改变的预测价值。结果:动态心电图缺血性改变受颈动脉有无斑块形成影响;动态心电图有无缺血性改变2组间斑块积分(z=-2.793,p=0.005)和斑块指数(z=-2.622,p=0.009)有统计学意义;颈动脉IMT的曲线下面积AUC=0.522,P>0.05;颈动脉斑块积分的AUC=0.708,p<0.05。结论:高血压患者心电图缺血性改变与颈动脉斑块之间呈正相关,颈动脉斑块积分对预测高血压患者出现发作性ST-T改变有一定预测价值。

Objective：To investigate the correlation between the formation of carotid plaques and the ischemic changes of Holter in hypertension.Methods：64 hypertention patient were divided in to two group by if they had the ST-T ischemic change in Holter.The corconary CTA of these patienst are normal or the corconary stenosis less than 30%.To screen the affecting factors of ischemic changes with logistic regression by two categories,and to compare two groups of patient＇s age,blood lipids,carotid IMT,carotid artery plaque score and plaque index difference,to establish the ROC curve,of carotid IMT and carotid artery plaque score.To assess the carotid IMT,carotid artery plaque score ischemic changes on ECG predictive value.Results：Carotid artery plaque is the factor of ST-T ischemic changes（z=-2.793,p=0.005）;artery plaque score and plaque index in significant difference between the two groups（z=-2.622,p=0.009）;carotid artery IMT of the AUC=0.522,P〉0.05;carotid artery plaque score of the AUC=0.708,p〈0.05.Conclusions：There is some correlation between ST-T Ischemic changes and carotid artery plaque in hypertensive patients,the carotid artery plaque score could predict IST-T schemic changes.