缺血性脑卒中患者动态心电图联合动态血压同步监测的结果及临床意义分析

Analysis of the results and clinical significance of ambulatory electrocardiogram combined with ambulatory blood pressure simultaneous monitoring in patients with ischemic stroke

目的通过对比缺血性脑卒中和非缺血性脑卒中患者的动态心电图及动态血压情况,分析动态心电图联合动态血压同步监测的临床价值和意义。方法 78例原发性高血压患者作为研究对象,其中48例患者发生缺血性脑卒中(脑卒中组), 30例患者未发生缺血性脑卒中(非脑卒中组)。对比两组患者的昼夜血压水平及血压异常发生情况;昼夜心律失常、ST段改变、T波改变发生情况;短暂性房颤、窦性心动过速、窦性心动过缓发生情况。结果两组患者白昼的收缩压(SBP)、舒张压(DBP)水平和血压异常发生率对比,差异均无统计学意义(P>0.05);脑卒中组夜间的SBP、DBP水平和血压异常发生率均高于非脑卒中组,差异均具有统计学意义(P<0.05)。两组患者白昼的心律失常、ST段改变、T波改变发生率对比,差异均无统计学意义(P>0.05);脑卒中组夜间的心律失常发生率31.3%、ST段改变发生率25.0%、T波改变发生率29.2%均高于非脑卒中组的10.0%、6.7%、10.0%,差异均具有统计学意义(P<0.05)。脑卒中组短暂性房颤发生率18.8%高于非脑卒中组的3.3%,差异具有统计学意义(P<0.05);两组患者的窦性心动过速、窦性心动过缓发生率对比,差异均无统计学意义(P>0.05)。结论利用动态心电图和动态血压同步监测能筛查脑卒中高危人群,做好脑卒中预防。

Objective By comparing the ambulatory electrocardiogram and ambulatory blood pressure of patients with ischemic stroke and non-ischemic stroke,the clinical value and significance of ambulatory electrocardiogram combined with ambulatory blood pressure simultaneous monitoring are analyzed.Methods 78 patients with essential hypertension were taken as the research subjects,of which 48 patients had ischemic stroke(stroke group)and 30 patients did not have ischemic stroke(non-stroke group).The diurnal blood pressure levels,abnormal blood pressure,occurrence of circadian arrhythmia,ST segment changes,T wave changes,occurrence of transient atrial fibrillation,sinus tachycardia,and sinus bradycardia of the two groups were compared.Results There was no significant difference in systolic blood pressure(SBP)and diastolic blood pressure(DBP)levels and the incidence of abnormal blood pressure during the day between the two groups of patients(P>0.05);the levels of SBP,DBP and occurrence of abnormal blood pressure at night in the stroke group were higher than those in the non-stroke group,and the differences were statistically significant(P<0.05).There was no significant difference in the incidence of arrhythmia,ST segment changes,and T wave changes during the day between the two groups(P>0.05);the incidence of arrhythmia,ST segment changes and T wave changes at night in the stroke group were 31.3%,25.0%,and 29.2%,which were higher than 10.0%,6.7%,and 10.0%in the non-stroke group,and the differences were statistically significant(P<0.05).The incidence of transient atrial fibrillation in the stroke group was 18.8%,which was higher than 3.3%in the non-stroke group,and the difference was statistically significant(P<0.05);there was no statistically significant difference in the incidence of sinus tachycardia and sinus bradycardia between the two groups(P>0.05).Conclusion The use of dynamic electrocardiogram and ambulatory blood pressure can screen the population at high risk of stroke and prevent stroke.