心电向量图诊断高血压早期心脏靶器官损害的临床应用及影响因素

The Diagnostic Value Vectorcardiogram the Early Stage Hypertensive Heart Target Organ Damage Analysis Influencing Factors

目的探讨心电向量图(vectorcardiogram,VCG)对高血压心脏电活动异常的诊断价值,并分析早期心脏靶器官损害的影响因素。方法选取昆明市中医医院心血管病科2022年1月至2023年2月的高血压病住院患者80例,经超声心动图(ultrasound cardiogram,UCG)排外心脏结构异常。比较心电图(electrocardiogram,ECG)与VCG对异常心室除极与复极指标的检出情况。按心电向量检查结果将80例病例分为正常组(n=40)与异常组(n=40),比较2组早期心脏损害的相关影响因素指标,将差异有统计学意义的因素做二元Logistic回归分析,筛选出早期心脏损害的独立影响因素。结果VCG检出异常心室复极指标较ECG有优势(P<0.05),二者对异常除极指标的检出差异无统计学意义(P>0.05)。正常组与异常组比较,在年龄、规律服药、家族史、糖尿病、24 h平均收缩压(24 h average systolic blood pressure,24 h SBP)、白昼平均收缩压(daytime average systolic blood pressure,DSBP)、夜间平均收缩压(night average systolic blood pressure,NSBP)、血压负荷值、清晨血压、脉压差等指标上,差异有统计学意义(P<0.05)。二元Logistic回归分析显示,年龄[OR(95%CI)=0.891,0.998]、夜间平均收缩压[OR(95%CI)=1.018,2.10]、家族史[OR(95%CI)=0.029,0.499]、糖尿病[OR(95%CI)=0.042,0.916]是高血压早期心脏损害的独立影响因素。结论VCG为高血压早期心脏靶器官损害的有效检测手段。

Objective To investigate the value of vectorcardiography in the diagnosis of abnormal cardiac electrical activity in hypertension,and to analyze the influencing factors of early cardiac target organ damage.Methods 80 cases in the Department of Cardiovascular of Kunming Municipal Hospital of Traditional Chinese Medicine from January 2022 to February 2023,were selected.Cardiac structural abnormalities were excluded by ultrasound cardiogram.The detection of abnormal ventricular depolarization and repolarization indexes was compared between electrocardiogram and vectorcardiogram.80 cases were divided into normal group(n = 40) and abnormal g roup(n = 40) according to the results of vectorcardiogram,the related influencing factors of early cardiac damage were compared between the two groups,and the indicators with statistical significance were included in the binary Logistic regression analysis to screen out the independent influencing factors of early heart damage.Results Vectorcardiogram was superior to ECG in detecting abnormal ventricular repolarization indexes(P < 0.05),and there was no significant difference in detecting abnormal depolarization indexes between the two groups(P > 0.05).There were significant differences between the normal group and the abnormal group in age,regular medication,family history,diabetes,24 h average systolic blood pressure(24 h SBP),daytime average systolic blood pressure(DSBP),night average systolic blood pressure(NSBP),blood pressure load,morning blood pressure,and pulse pressure(P < 0.05).Binary Logistic regression analysis showed,that age [OR(95%CI) = 0.891,0.998] and NSBP [OR( 95%CI) = 1.018,2.10],family history [OR( 95% CI) = 0.029,0.499],diabetes [OR =0.042( 95%CI),0.916] were the independent influencing factors of early cardiac damage in hypertension.Conclusion Vectorcardiogram is an effective method to detect early cardiac target organ damage in hypertension.