心电图ST-T改变在老年高血压合并冠心病的诊治中的应用价值

The Application Value of Electrocardiogram ST-T Changes in the Diagnosis and Treatment of Elderly Hypertension combined with Coronary Heart Disease

目的 探讨心电图ST-T改变对老年高血压合并冠心病的诊断价值分析,以期为临床早期诊断、制定干预方案提供参考。方法 选取100例郑州市第七人民医院2022年1月至2023年6月就诊的高血压患者作为研究组,另选取100例同期健康体检患者作为对照组,均行心电图检查,比较两组不同高血压分级及合并、未合并冠心病、不同冠脉病变支数、冠脉狭窄程度患者心电图ST-T改变情况(ST段缺血性压低、V1-V6T波直立V1T> V5T、V4-V6T波低平或倒置),分析ST-T改变情况与高血压分级、冠脉病变支数、冠脉狭窄程度相关性。结果 与对照组比较,研究组心电图ST段缺血性压低、V1-V6T波直立V1T> V5T、V4-V6T波低平或倒置检出率较高,差异均有统计学意义(P <0.05);不同高血压分级患者心电图ST段缺血性压低、V1-V6T波直立V1T> V5T、V4-V6T波低平或倒置检出率比较:高血压Ⅲ级>高血压Ⅱ级>高血压Ⅰ级,差异具有统计学意义(P<0.05);与未合并冠心病患者比较,合并冠心病患者心电图ST段缺血性压低、V1-V6T波直立V1T> V5T、V4-V6T波低平或倒置检出率较高,差异均有统计学意义(P <0.05);不同冠脉病变支数患者心电图ST段缺血性压低、V1-V6T波直立V1T> V5T、V4-V6T波低平或倒置检出率比较:多支病变>双支病变>单支病变,差异具有统计学意义(P <0.05);不同冠脉狭窄程度患者心电图ST段缺血性压低、V1-V6T波直立V1T> V5T、V4-V6T波低平或倒置检出率比较:重度狭窄>中度狭窄>轻度狭窄,差异具有统计学意义(P<0.05);心电图ST段缺血性压低、V1-V6T波直立V1T> V5T、V4-V6T波低平或倒置检出率与高血压分级、冠脉病变支数、狭窄程度均呈显著正相关,具有统计学意义(P<0.05)。结论 心电图ST段改变可用于老年高血压合并冠心病诊断中,为临床早期评估高血压及冠心病病情提供参考,以针对性制定治疗方案。

Objective To explore the diagnostic value of electrocardiogram ST-T changes in elderly patients with hypertension and coronary heart disease,in order to provide reference for early clinical diagnosis and intervention plans.Methods One hundred hypertensive patients who visited our hospital from January 2022 to June 2023 were selected as the study group,and another 100healthy patients who underwent physical examinations during the same period were selected as the control group,all of whom underwent electrocardiogram examinations.Compare the changes in electrocardiogram ST-T(ST segment ischemic depression,V1-V6T wave upright V1T > V5T,V4T-V6T wave low flat or inverted) between two groups,patients with different hypertension grades and concomitant or non concomitant coronary heart disease,different number of coronary lesion branches,and degree of coronary stenosis,and analyze the correlation between ST-T changes and hypertension grades,coronary lesion branches,and degree of coronary stenosis.Results Compared with the control group,the study group had a higher detection rate of ST segment ischemic depression,V1-V6T wave upright V1T > V5T,and V4T-V6T wave low flat or inverted(P<0.05).Comparison of detection rates of ST segment ischemic depression,V1-V6T wave upright V1T > V5T,and V4T-V6T wave low flat or inverted in patients with different hypertension grades:hypertension grade Ⅲ > hypertension grade Ⅱ > hypertension grade Ⅰ(P <0.05).Compared with patients without concomitant coronary heart disease,patients with concomitant coronary heart disease had a higher detection rate of ST segment ischemic depression,V1-V6T wave upright V1T > V5T,and V4T-V6T wave flat or inverted(P < 0.05).Comparison of detection rates of ST segment ischemic depression,V1-V6T wave upright V1T >V5T,and V4T-V6T wave low flat or inverted in patients with different coronary artery disease branches:multi branch disease >double branch disease > single branch disease(P < 0.05).Comparison of detection rates of ST segment ischemic depression,V1-V6T wave upright V1T > V5T,and V4T-V6T wave low flat or inverted in patients with different degrees of coronary stenosis:severe stenosis > moderate stenosis > mild stenosis(P < 0.05).The detection rates of ST segment ischemic depression,V1-V6T wave upright V1T > V5T,and V4T-V6T wave low flat or inverted in electrocardiogram were significantly positively correlated with hypertension grade,number of coronary lesion branches,and degree of stenosis(P<0.05).Conclusion The ST segment changes in electrocardiogram can be used for the diagnosis of elderly hypertension combined with coronary heart disease,providing reference for early clinical evaluation of hypertension and coronary heart disease,and formulating targeted treatment plans.