高血压性左室肥厚患者的校正QT间期离散度变化及临床意义

Changes and clinical significance of corrected QT dispersion in hypertensive patients with left ventricular hypertrophy

目的：研究高血压性左室肥厚（ＬＶＨ） 患者的ＱＴｃｄ 变化及临床意义。方法：采用１２ 导联心电图同步记录、超声检查和动态心电图监测５６ 例高血压病患者的ＱＴｃｄ 、心脏形态和心律失常。结果：高血压病组与对照组间ＱＴｃｄ 差异非常显著，高血压伴ＬＶＨ 组和（ 或） 室性心律失常（ ＶＡｓ） 组的ＱＴｃｄ 均显著长于无伴ＬＶＨ 组和（ 或） 无ＶＡｓ 组；ＬＶＨ 组ＶＡｓ 和复杂型心律失常发生率均显著高于无ＬＶＨ 组。结论：高血压伴ＬＶＨ 和（ 或）ＶＡｓ 患者心室肌存在明显的心电不稳定性和复极不均匀性。ＱＴｃｄ 和ＬＶＨ 及ＶＡｓ 三者关系密切，ＱＴｃｄ 延长可作为ＬＶＨ

AIM:To study the changes and clinical significance of QTcd in hypertensive left ventricular hypertrophy (LVH).METHODS:QTcd, cardiac shape and VAs were measured by electrocardiography at rest, colour doppler echocardiography and 24 h ambulatory electrocardiography were observed in 56 patients with hypertension.RESULTS:QTcd was significantly prolonged in hypertensive patients compared with control group, and it is clinically important that QTcd had obvious differences between LVH and without LVH or VAs and without VAs. The incidences of VAs and complex VAs in 27 cases with LVH were significantly higher than that in 29 cases without LVH.CONCLUSION:There is marked imbalance in the repolarization of myoardium and instability of cardiac electrical activity in hypertensive patients, particularly with LVH and/or VAs. There is a positive correlation between QTcd, LVH and VAs; QTcd may be an indication of complex ventricular arrhythmia risk in patients with hypertensive LVH.