高血压左室构型与跨室壁复极离散度关系的研究

目的探讨高血压患者左室构型与跨室壁复极离散度的关系。方法根据超声心动图所测指标将高血压患者分为4组，利用体表心电图计算出T波峰-末间期（Tpeak—Tend interval，Tpe）和Tpe／QT。结果①向心性肥厚患者Tpe值（ms）与正常构型组相比增高（男性：109．2±12-3和80．3±12．6，P〈0．05；女性：104．6±13．2和82．3±14．1，P〈0．05）；Tpe／QT值也有相同的结果（男性：0．26±0．10和0．19±0．03，P〈0．05；女性：0．25±0．05和0．20±0．02，P〈0．05）。②离心性肥厚患者Tpe值（ms）与正常构型组相比增高（男性：114．2±14．3和80．3±12．6．P〈0．05；女性：110．3±12．5和82．3±14．1，P〈0．05）；Tpe／QT值也有相同的结果（男性：0．29±0．09和0．19±0．03，P〈0．05；女性：0．28±0．10和0．20±0．02，P〈0．05）。③向心性重构组与正常构型组对比，Toe值（ms）差异无统计学意义（男性：79．9±11．6和80．3±12．6，P〉0．05；女性：80．1±10．5和82．3±14．1，P〉0．05）；Tpe／QT值也有相同的结果（男性：0．21±0．08和0．19±0．03，P〉0．05；女性：0．19±0．03和0．20±0．02，P〉0．05）。结论高血压病患者左室构型异常的程度与Tpe和Tpe／QT值增高相一致。推测向心性肥厚型和离心性肥厚型高血压患者易发生房室性心律失常。

Relationship between left ventricular geometry and transmural dispersion of repolarization

Objective Study on relationship between left ventricular geometry and transmural dispersion of repolarization. Methods Hypertensive patients were selected and divided into four groups based on their Doppler echocardiography. The Tpeak-Tend Interval（Tpe） and Tpe/QT ratio were measured and compared by surface electrocardiogram among groups. Results （1）Patients in concentric hypertrophy group had higher Tpe interval when compared with those in normal ventricular geometry group （109.2±12.3 vs 80.3±12.6,P〈0.05 for male）, （104.6±13.2 vs 82.3±14.1,P〈0.05 for female）. At the same time, patients in concentric hypertrophy group had higher Tpe/QT ration （0.26±0.10 vs 0.19±0.03,P〈0.05 for male）,（0.25±0.05 vs 0.20±0.02,P〈0.05 for female）. （2）Patients in eccentric hypertrophy group had higher Tpe interval when compared with those in normal ventricular geometry group （114.2±14.3 vs 80.3±12.6,P〈0.05 for male）,（110.3±12.5 vs 82.3±14.1,P〈0.05 for female）. At the same time, patients in eccentric hypertrophy group had higher Tpe/QT ration（0.29±0.09 vs 0.19±0.03 ,P〈0.05 for male）, （0.28±0.10 vs 0.20±0.02,P〈0.05 for female）. （3）There was no statistical significant difference between concentric remodeling group and normal ventricular geometry group for Tpe interval （79.9±11.6 vs 80.3±12.6,P〉 0.05 for male）, （80.1±10.5 vs 82.3±14.1 ,P〉0.05 for male）or Tpe/QT ratio （0.21±0.08 vs 0.19±0.03,P〉0.05,for male）, （0.19±0.03 vs 0.20±0.02,P〉0.05 for female）. Conclusion The extent of left ventrieular abnormality is consistent with the increase of Tpe interval and Tpe/QT ration. It is suggested that atrial or ventricular arrhythmia is more likely to occur in hypertensive patients with concentric hypertrophy and eccentric hypertrophy.