高血压并发脑卒中患者心电图ST—T改变的临床意义

Clinical value of electrocardiographic ST-T abnormalities in hypertensive patients with stroke

目的探讨高血压并发脑卒中患者心电图ST-T改变的临床意义。方法将167例高血压患者分为高血压并脑卒中组（78例）和单纯高血压组（89例）。入选病例均进行常规心电图检查，分析ST—T改变情况，测量Sokolow—Lyon（SL）电压值。结果高血压并脑卒中组患者ST—T改变的发生率为47．4％，单纯高血压组患者ST—T改变的发生率为31．5％，两组间比较差异有统计学意义（P〈0．05）。与无ST-T改变者比较，高血压患者有ST—T改变者的血压水平、SL电压值均较高（P〈0．05）。在校正性别、年龄因素后，高血压患者收缩压、舒张压和SL电压值与心电图ST-T改变的发生呈显著正相关（P〈0．05），OR值分别为1．024（95％CI：1．010～1．039）、1．033（95％CI：1．006—1．060）和1．087（95％CI：1．034—1．143）。结论高血压并发脑卒中患者心电图ST—T改变的发生率较高。高血压患者心电图ST—T改变与血压水平和左室重量具有相关性。

Objective To assess the clinical value of ST-T abnormalities in hypertensive patients with stroke. Methods Totally 167 patients with essential hypertension were classified into two groups ：78 cases with stroke and 89 cases without stroke. All patients underwent standard electrocardiography. Elec- trocardiographic ST-T changes were analysed and Sokolow-Lyon voltages were measured. Results The prevalence of ST-T abnormalities in hypertensive patients with stroke was higher than in those without （47.4% vs 31.5% ,P 〈 0.05 ）. Compared with patients without ST-T abnormalities, patients with ST-T abnormalities had higher blood pressure levels and Sokolow-Lyon voltage values（ P 〈 0.05 ）. After adjust- ment for sex and age, higher SBP, DBP and SL voltage were significantly associated with higher incidence of electrocardiographic ST-T abnormalities （P 〈 0.05 ）. The OR （95% CI ） were 1. 024 （ 1. 010-1. 039 ）, 1.033（1.006-1.060） and 1. 087（1.034-1. 143） ,respectively. Conclusions The prevalence of ST-T abnormalities is increased in hypertensive patients with stroke. ST-T abnormality on electrocardiography is associated with increased blood pressure and left ventricular mass in essential hypertension.