高血压病的P波改变与左室舒张功能相关性研究

Study of the Relationship Between P Wave Abnormalities and Left Ventricular Diastolic Filling in Patients with Hypertension

目的：研究高血压病的Ｐ波改变与左室舒张功能相关性，为早期估测高血压病的心功能变化提供依据。方法：对８７例高血压患者测量血压、描记标准１２导联心电图及进行超声心动图检查，对比Ｐ波指标正常与异常组的其他参数（包括血压、年龄、病程及左室舒张功能等）差异，计算Ｐ波指标与其他参数的相关系数。结果：Ｍａｃｒｕｚ指数、Ｐ波宽度及Ｖ１导联心房终东电势（ＰＴＦＶ１）异常分别为６６％、６０％和４８％，且高血压患者Ａ峰、Ａ／Ｅ比值升高。Ｍａｃｒｕｚ指数和 Ｐ波宽度与Ａ峰、Ａ／Ｅ比值和病程正相关，ＰＴＦＶ１与Ａ／Ｅ比值负相关。结论：高血压病的Ｐ波异常是普遍存在的，它反映了左室舒张功能障碍。

Objective: The aim of this study was to evaluate the relationship between P wave abnormalities and the functional indexes of left ventricular filling obtained by pulse wave Doppler echocardiography in hypertensive patients. The evidence was given for early evaluating heart function in hypertension. Methods: Eighty - seven hypertensive patients were included in this study. Blood pressures were measured at the time of the study, a complete 12 - lead ECG was recorded, and an echo - Doppler study was made. The other parameters (blood pressure, age, hypertensive duration, and left ventricle diastolic filling) were compared among patients. The correlation coefficients between atrial ECG indexes and the other parameters under this study were calculated. Results: Fifty - seven (66 %) had a Macruz index (PAR) greater than 1. 6 , 52 (60 %) had P wave duration longer than 0. 10 second, and 42 (48 % ) had terminal forces of P wave in lead V1(PTFV1) greater than 0. 04. The hypertensive patients presented in diastolic dysfunction of left ventricle (a higher Doppler A peak and A/E ratio). In the present study, a positive correlation was revealed between Macruz index or P wave duration and A peak, Am ratio, and hypertensive duration. An inverse correlation was revealed between PTFVI and A/E ratio. Conclusion: Left atrial ECG abnormalities common in hypertension, Which suggests diastolic dysfunction of left ventricle.