动态心电图与动态血压联合监测高血压患者心肌缺血和心律失常

Combination of DCG and ABP for synchronously monitoring myocardial ischemia and arrhythmia in hypertensive patients

目的:探讨动态心电图(dynamic electrocardiogram,DCG)和动态血压(ambulatory blood pressure,ABP)同步监测高血压患者血压变化与心肌缺血、心律失常的关系。方法:对280例高血压患者分6个时段作ABP及DCG同步监测高血压患者血压变化与心肌缺血、心律失常的改变。结果:血压波动与心肌缺血、心律失常的发生密切相关(γ=0.73、γ=0.78,P<0.01);血压波动以第一时段(6∶00-10∶00)较为显著(P<0.01)。结论:高血压患者的心肌缺血和心律失常发生,与血压波动与升高密切相关。DCG和ABP同步监测高血压患者血压变化与心肌缺血、心律失常,更具临床指导意义。

Objective ： To investigate dynamic electrocardiogram （DCG） combined with ambulatory blood pressure （ABP） on synchronously monitoring relationships between the changes of blood pressure and myocardial ischemia （MI） and/or arrhythmia in hy- pertensive patients. Methods ： 280 cases of hypertension were simultaneously monitored by ABP and DCG for six periods, which fluc- tuation and/or rise in blood pressure affected changes of myocardial ischemia and/or arrhythmia. Results： The myocardial ischemia and arrhythmia were directly bound up with the fluctuation of blood pressure （γ=0. 73,γ =0. 78, P 〈0. 01 ） ; the fluctuation of blood pressure was more obvious in the first period （6：O0 -10： 00）. Conclusion： The fluctuation and/or rise in blood pressure are closely related with myocardial ischemia and arrhythmia in hypertensive patients. DCG combined with ABP on synchronously monitoring rela- tionships between the changes of blood pressure and MI and/or arrhythmia possess more clinical significance in hypertensive patients.