原发性高血压患者心脏靶器官损害的心电图特点

Electrocardiographic Characteristics of Cardiac Target Organ Damage in Patients with Essential Hypertension

目的探讨原发性高血压患者心脏靶器官损害的心电图改变特点,定性定量分析不同血压水平下各指标改变的意义。方法回顾性分析2021年10月至2022年11月在郑州大学第二附属医院门诊、住院及体检确诊为原发性高血压,且均行常规心电图、动态血压检查的159例患者的临床资料。依据动态血压检查结果,按照全天收缩压/舒张压均值水平分为A、B、C 3个亚组,采用方差分析和χ2检验比较不同组间心电图改变,总结原发性高血压患者心脏靶器官损害的心电图特点。结果原发性高血压患者心电图异常率高(93.1%),主要表现为心房波/心室波异常(73.0%)、ST-T改变(55.3%)、心律失常(20.8%)。原发性高血压患者心电图异常有性别差异,男性多表现心房波/心室波异常,而女性多表现ST-T改变。原发性高血压患者不同血压水平亚组之间,心房波/心室波异常差异有统计学意义(P<0.05),而年龄、ST-T改变、心律失常差异无统计学意义(P>0.05)。原发性高血压患者不同血压水平亚组之间,心房波/心室波异常、ST-T改变、心律失常各指标定性分析中差异无统计学意义(P>0.05),表现为P波时限≥120 ms,Macrua指数>1.6,ST段水平型压低,T波低平、倒置发生率占比大。原发性高血压患者不同血压水平亚组之间,心房波/心室波异常、ST-T改变、心律失常各指标定量分析中,ST段水平型压低和T波倒置程度随血压水平升高而加重,差异有统计学意义(P<0.05)。结论原发性高血压患者靶器官损害心脏电学异常发生率高,应用心电图检查可定性、定量分析不同血压水平对心脏靶器官损害的程度。

Objective In order to investigate the characteristics of electrocardiogram changes of target organ damage in patients with essential hypertension,and to analyze the significance of the changes of each index qualitatively and quantitatively.Methods The clinical date of 159 patients diagnosed with essential hypertension in out-patient,in-patient and physical examination in the Second Affiliated Hospital of Zhengzhou University from October 2021 to November 2022,who underwent routine electrocardiogram and ambulate blood pressure examination were retrospectively analyzed.According to the results of ambulatory blood pressure examination,the patients were divided into three subgroups(A,B and C)according to the mean systolic blood pressure/diastolic blood pressure in the whole day.Anova andχ2 test were used to compare the electrocardiogram changes among different groups,and the ECG characteristics of heart target organ damage in patients with essential hypertension were summarized.Results The abnormal rate of electrocardiogram in patients with essential hypertension was high(93.1%),mainly manifested as abnormal atrial/ventricular waves(73.0%),ST-T changes(55.3%),arrhythmia(20.8%).There were gender differences in electrocardiogram abnormalities in patients with essential hypertension,male patients had more abnormal atrial/ventricular waves,while female patients had more ST-T changes.There were significant differences in abnormal atrial/ventricular waves among different blood pressure subgroups of patients with essential hypertension(P<0.05),but there were no significant differences in age,ST-T changes and arrhythmia(P>0.05).There was no significant difference in the qualitative analysis of the indexes of abnormal atrial/ventricular waves,ST-T changes and arrhythmia among the subgroups with different blood pressure levels(P>0.05),which showed that P wave duration≥120 ms,macrua index>1.6,ST segment horizontal depression,flat or inversed,the incidence of such indexes were higher than other.In the quantitative analysis of atrial/ventricular wave abnormalities,ST-T changes and arrhythmias in patients with essential hypertension with different blood pressure subgroups,ST segment horizontal depression and T wave inversion increased with the increase of blood pressure,and the difference was statistically significant(P<0.05).Conclusion The incidence of cardiac electrical abnormalities is high in patients with essential hypertension.Electrocardiogram can be used to qualitatively and quantitatively analyze the damage degree of cardiac target organs caused by different blood pressure levels.