心电图P波增宽与双峰对隐匿性高血压患者心脏损害的预测价值

Predictive value of P wave broadening and dual-peak variation on ECG for early cardiac damage in patients with masked hypertension

目的：研究心电图P波增宽以及双峰变化对隐匿性高血压（MH）患者的心脏损害的预测价值。方法：选择于我院就诊隐匿性高血压患者120例（隐匿性高血压组），同时期的真性高血压患者120例（高血压对照组），结合两组心电图改变情况，分析隐匿性高血压患者心电图P波增宽和双峰改变与患者心脏损害的关系。结果：与高血压对照组比较，隐匿性高血压组左室肥大（25．00％比6．67％）、左房肥大（26．67％比10．00％）、房室阻滞（21．67％比4．17％）以及ST-T改变（53．33％比12．50％）的发生率明显降低（P〈0．05或〈0．01）；在P波增宽以及P波双峰的发生率，高血压对照组也略高于隐匿性高血压组，但差异无统计学意义（P均〉0．05）。经Logistic回归分析发现，P波增宽以及双峰改变与左室肥大、左心房肥大、房室阻滞以及ST-T改变具有显著相关性（OR=1．103～7．674，P均〈0．01）。结论：心电图P波增宽与双峰变化对隐匿性高血压患者的心脏损害具有预测价值。

Objective： To study predictive value of P wave broadening and dual-peak variation on ECG for cardiac damage in patients with masked hypertension （MH）. Methods： A total of 120 MH patients treated in our hospital were selected as MH group, another 120 patients with true hypertension were treated as hypertension control group. Relationship among P wave broadening, dual- peak variation and ECG changes of cardiac damage was analyzed in two groups. Results： Compared with hypertension control group, there were significant reductions in incidence rates of left ventricular hypertrophy （25.00% vs. 6.67% ）, left atrial hypertrophy （26.67% vs. 10.00%）, atrioventricular block （21.67% vs. 4.17% ） and ST-T changes （53.33% vs. 12.50% ） in MH group, P〈0.05 or 〈0. 013 incidence rates of P wave broadening and dual- P wave in hypertension control group were slightly higher than those of MH group without significant difference, P〉0.05 both. Logistic regression analysis indicated that P wave broadening and dual- peak variation were significantly correlated with left ventricular hypertrophy, left atrial hypertrophy, atrioventricular block and ST-T changes （OR = 1. 103-7. 674, P〈0.01 all）. Conclusion： P wave broadening and dualpeal variation on ECG possess predictive value for cardiac damage in patients with masked hypertension.