高血压患者血压昼夜节律与心肌缺血心律失常的关系

摘要

目的：探讨高血压患者血压昼夜节律与ST-T异常改变以及心律失常之间的关系，为临床治疗提供可靠依据。方法：对56例高血压病患者同步检测24 h动态血压（ABP）和动态心电图（DCG），分析其血压昼夜节律变化与发生心肌缺血、心律失常之间的关系。结果：血压昼夜节律下降、消失占83.9%，呈非杓型ABP曲线占76.8%；DCG有ST-T改变分别占28.5%和55.3%；房性、室性心律失常较多见分别占78.5%和39.2%；ST-T改变和房性、室性心律失常与ABP血压昼夜节律异常（白天最低值）及最高值有显著相关性（P<0.05）。结论：24 h ABP和DCG同步监测高血压患者，其血压昼夜节律异常与心肌缺血、心律失常有密切关系，更具有临床指导意义。%Objective:To explore the relationship of the ambulatory blood pressure(ABP)and dynamic electrocardiogram(DCG) simultaneous monitoring the patients with hypertension between circadian rhythms,myocardial ischemia and arrhythmia. To provide the basis for clinical treatment.Method:56 cases of hypertension were simultaneously monitored by ABP and DCG for six periods. which fluctuation and rise in blood pressure affected changes of circadian rhythms,myocardial ischemia and arrhythmia.Result:Circadian rhythms of ABP disappeared in 83.9%. ABP curve was of non-dipper-like pattern in 76.8%.DCG with ST-T changed 28.5%,55.3%,and atrial and ventricular arrhythmias were 78.5%, 39.2%,ST-T changed and atrial and ventricular arrhythmias highest value with ABP and circadian rhythm abnormalities(daytime lowest value)were significantly associated(P<0 05).Conclusion:DCG combined with ABP on synchronously monitoring relationships between the changes of blood pressure and MI and/or arrhythmia possess more clinical significance in hypertensive patients.