冠心病患者心率变化、血压与心肌缺血改变的相关性研究

The correlative study of heart rate changes, blood pressure and myocardial ischemia in patients with coronary heart disease

目的根据监测清晨血压变化参数与对应时域的缺血ST段演变相关性,探讨冠心病合并高血压患者心率变化、血压是否与心肌缺血改变存在相关性。方法对2010年2月～2011年2月90例冠心病合并高血压患者(高血压组)及66例单纯冠心病患者(对照组),行24h动态心电图及同步动态血压监测,获得的心率、清晨血压波动值和ST段压低持续时间进行相关性统计学分析及研究结论。结果高血压组的清晨血压升值与对应时域的ST段压低有正相关性关系;尤以清晨血压回升差值(收缩压、平均脉压、舒张压)和心率与对应ST段压低有显著正相关性,而对照组无明显相关性。结论清晨清醒前后血压升高与心肌缺血的发生呈正相关关系,且多为无痛性心肌缺血。

Objective To explore whether there were correlations of heart rate changes, blood pressure and myocardial ischemia in patients with coronary heart disease and hypertension, according to the correlation of blood pressure parameters monitored in the early morning and ischemia ST segment evolution in the corresponding time domain. Methods Ninety patients with coronary heart disease and hypertension （hypertension group） and 66 patients with coronary artery disease （control group） from February 2010 to February 2011 were taken 24 hour dynamic electrocardiogram and synchronous ambulatory blood pressure monitoring. The results of the heart rate, blood pressure index in the early morning and the lasting time of ST segment depression were making correlation analysis statistically and the conclusion was studied. Results There was a positive correlation relationship between the value of blood pressure rising up in the early morning and ST segment depression in the corresponding time domain in the hypertension group; there was a significant correlation between the difference of raised blood pressure in the early morning （systolic blood pressure, average pulse pressure, diastolic blood pressure） and heart rate with the corresponding ST segment depression, while there was no significant correlation in the control group. Conclusion There is a positive correlation of the raised blood pressure with or without waking up in the morning and the myocardial ischemia changes, with silent myocardial ischemia in most.