原发性高血压心律失常与血脂、血糖、纤维蛋白原、血尿酸关系的研究

Association of Arrhythmia with Cardiovascular Risk Factors in Essential Hypertension

目的 探讨首次诊断的原发性高血压患者心律失常的发现率、类型及其与高血压水平和心血管危险因素的关系。方法 1995 .6～ 2 0 0 1.3首次诊断的原发性高血压 12 16例 ,用 2 4小时动态心电图监测心律失常 ,测定血压、血脂、血糖、纤维蛋白原、血尿酸等指标 ,用方差分析和相关回归分析统计结果。结果 5 14例患者出现心律失常 ,发生率为4 2 .3% ,2 6 8例出现室性心律失常 ,发生率为 2 2 .0 4 % ,370例出现室上性心律失常 ,发生率为 30 4 % ,6 8例出现传导阻滞及其他心律失常 ,发生率为 5 .6 %。各种心律失常的发生率随血压级别的增高而增高 ,室性心律失常的发生与总胆固醇脂、甘油三脂、血糖、纤维蛋白原、血尿酸呈正相关 (r =0 4 3,0 2 4 ,0 36 ,0 5 1,0 37) ,室上性心律失常的发生与总胆固醇脂、甘油三脂、血糖、纤维蛋白原呈正相关 (r =0 2 8,0 32 ,0 34,0 4 4 )。传导阻滞及其他心律失常与血尿酸呈正相关 (r =0 4 1)。结论 首次诊断的原发性高血压患者 ,心律失常的发生率高 ,心律失常的发生与高血压水平及心血管危险因素有关 ,控制高血压 ,消除心血管危险因素是防治心律失常发生的手段。

Objective To evaluate the type and incidence of arrhythmia in patients with essential hypertension and it correlation with blood pressure level and cardiovascular risk factors. Methods Arrhythmia in 1216 patients with essential hypertension were collected between June 1995 and March 2001 .\ Arrhythmia were monitored with ambulatory electrocardiogram. Risk factors including blood pressure, blood lipid, blood sugar, plasma fibrinogen, uric acid determined. Results Analysis of variance and multivariate logistic stepwise regression showed that arrhythmia incidence was 42.3%(514/1216), with ventricular arrhythmia of 22.4%, supraventricular arrhythmia of 30 4%(370/1216).\ 68 patients had conduction block and other arrhythmia. Conclusion The prevalence rate of arrhythmia was related with the level of BP and various risk factors. The higher the blood pressure, the more arrhythmia was shown.\ Ventricular arrhythmia was positively related to total cholesterol, triglyceride, glucose, fibrinogen and uric acid(\%r\%=0 43, 0 24, 0 36, 0 51, 0 37).\ Supraventricular arrhythemia was related to cholesterol, triglyceride,glucose and fibrinogen(\%r\%=0 28,0 32,0 34,0 44). Conduction block was correlated to serum uric acid(\%r\%=0 41).