摘要
目的通过动态血压监测（ＡＢＰＭ）清晨血压变化参数与动态心电图（Ｈｏｌｔｅｒ）对应时域的缺血性ＳＴ段演变的相关性研究，观察高血压合并冠心病患者血压改变是否与Ｈｏｌｔｅｒ所示心肌缺血改变存在相关性。方法对７９例高血压合并冠心病患者，行同步ＡＢＰＭ与Ｈｏｌｔｅｒ检查２４ｈ，获得的血压变化和ＳＴ段压低数据由计算机进行统计分析。结果清晨血压（收缩压、平均脉压、舒张压）与对应时域的ＳＴ段压低呈正相关关系（Ｐ＜０．０５，ｒ＝０．３９，０．１８，０．３３）；尤以血压（收缩压、平均脉压、舒张压）回升值、心肌耗氧量与夜间均值之差跟对应ＳＴ段压低的相关性更为显著（Ｐ＜０．０１，ｒ＝０．３８，０．１３，０．２９，０．２３）。昼夜节律消失组较昼夜节律存在组发生ＳＴ段缺血性改变的构成比具有显著性差异（Ｐ＜０．０５）。结论清晨清醒前后血压升高与心肌缺血的发生呈直线正相关，且多为无痛性心肌缺血，尤以昼夜节律消失者为著。
Aim\ To investigate the relationship between morning blood pressure surge and corresponding ischemic ST segment depression in hypertension patients with coronary heart disease.\ Methods\ Seventy nine patients with hypertension and coronary heart disease(CHD) were monitored with ambulatory blood pressure monitoring and Holter in the mean time for twenty four hours. The data of blood pressure and ST segment depression were calculated and analysed by a computer.\ Results\ There was a positive correlation between morning blood pressure(SBP,MAP,DBP) surge and the ST segment depression in the corresponding time (P<0 05,r=0 39, 0 18, 0 33, respectively), especially between the increase values of morning blood pressure(SBP,MAP,DBP), MVO 2 and ST segment depression(P<0 01,r=0 38, 0 13, 0 29, 0 23, rspectively).\ In the blood pressure non dipper group, the occurence of ST segment depression was higher than that of the dipper group(P<0 05).\ Conclusion\ There is a positive linear correlation between morning blood pressure increases and myocardiac ischemia.\ The ischemic changes in most cases are silent.
出处
《高血压杂志》
CSCD
1998年第3期166-169,共4页
Chinese Journal of Hypertension
关键词
动态血压
心肌缺血
冠心病
高血压
ambulatory blood pressure
\ myocardial ischemia
\ coronary heart disease
\ hypertension
