妊娠期高血压疾病孕妇心电图变化及临床意义

摘要

Objective To investigate the ECG changes in hypertensive disorders complicating pregnancy (HDCP).Methods From July 2013 to October 2015, 46 patients with HDCP in Zhoushan Maternal and Child Health Hospital were selected in HDCP group and 30 normal pregnant women who gave birth in the hospital were selected in control group .Disease information and ECG parameters were compared between two groups.Results HR of HDCP group was lower than that of the control group (t=4.017, P<0.05).RR interval, P wave width, QT interval, QTc period, QTd were higher than the control group (t value was 5.034, 3.976, 6.138, 4.863 and 6.342, respectively, all P<0.05), but there was no significant difference in QRS width between two groups ( P>0.05).Clinical diagnosis ( cardiovascular event such as myocardial ischemia in simple hypertensive patients ) was independent influencing factors for QTd ( F=6.260, P<0.05).Clinical diagnosis, systolic blood pressure and magnesium sulfate were independently associated with QTc (P value was 0.040, 0.028 and 0.013).Conclusion Ventricular repolarization prolongs significantly in HDCP cases , but the correlation between abnormal ventricular repolarization and risk of cardiovascular events needs further studies .%目的：探讨妊娠期高血压疾病（ HDCP）患者心电图变化情况。方法收集2013年7月至2015年10月在舟山市妇幼保健院就诊的HDCP患者46例（ HDCP组），选择同期住院分娩的正常孕妇30例作为对照组，比较两组病情资料和心电图检查参数。结果 HDCP组心率低于对照组（t＝4．017，P＜0．05），RR间期、P波宽度、QT间期、QTc间期、QTd均大于对照组（t值分别为5．034、3．976、6．138、4．863、6．342，均P＜0．05），而QRS波群宽度组间比较差异无统计学意义（P＞0．05）；临床诊断，即单纯高血压患者心肌缺血等心血管事件是QTd的独立影响因素（F＝6．260，P＜0．05），临床诊断、收缩压和硫酸镁则是QTc的独立影响因素（P值分别为0．040、0．028和0．013）。结论 HDCP患者出现明显心室复极化延长，但异常心室复极与心血管事件风险的相关性还需要更多研究证实。