原发性高血压患者心电图左室肥厚与心血管事件的相关性

目的：探讨原发性高血压患者降压治疗后血压及左心室肥厚情况的变化,以 Cornell-QRS 标准和 Sokolow-Lyon 电压判断左心室肥厚对主要心脑血管不良事件的预测价值。方法对174例原发性高血压患者进行前瞻性观察研究,心肌肥厚者50例(心肌肥厚组),无心肌肥厚者124例(非心肌肥厚组)。记录基线、6个月、1年、2年血压、心电图 Cornell-QRS 标准和Sokolow-Lyon 电压值,比较组间差异,并以 Cox 危险模型分析高血压左心室肥厚患者主要心脑血管不良事件生独立预测因素。结果与无心肌肥厚组相比,心肌肥厚组高血压病史更长(P <0.05),3级高血压比例明显更高(P <0.05),24 h 平均 SBP 更高(P <0.05)。与基线值相比,心肌肥厚组6个月、1年、2年 SBP、DBP、Cornell-QRS 指数和 Sokolow-Lyon 电压均显著下降(P <0.05)。与无心肌肥厚组相比,心肌肥厚组2年内非致死性心肌梗死和脑卒中的发生比例明显更高3(6.0%)vs .1(0.8%),P <0.05；6(12.0%)vs .2(1.6%),P <0.01]。Cornell-QRS 指数和 Sokolow-Lyon 电压是非致死性心肌梗死和脑卒中的独立预测因子。结论Cornell-QRS 指数和 Sokolow-Lyon 电压可能作为原发性高血压患者非致死性心肌梗死和脑卒中的独立预测因子。

Correlation of left ventricular hypertrophy detected by electrocardiogram and main cardiovascular accidents in hypertension patients

Objective To analyze the predicting value of Cornell-QRS standard and Sokolow-Lyon voltage to left ventricular hypertrophy in hypertensive patients.Methods One hundred and seventy-four patients with primary hypertension were enrolled, who were divided into left ventricular hypertrophy group (LVH group,n=50)and non-LVH group(n=124).The blood pressure, Cornell-QRS standard and Sokolow-Lyon voltage were collected and compared in the following-up period.Results Compared with non-LVH group,in LVH group the history of hypertrophy was longer(P <0.05),percent of grade 3 hypertrophy was higher(P <0.05),and 24 h SBP was higher(P <0.05).During the following-up of 6 months,1 year,2 year,the SBP (systolic blood pressure), DBP (diastolic blood pressure),Cornell-QRS standard and Sokolow-Lyon voltage in LVH patients were all significantly decreased (P <0.01).Compared with non-LVH group,the incidence of non-fatal myocardial infarction and stroke was higher in LVH group 3(6.0%)vs .1(0.8%),P <0.05;6 (12.0%)vs .2 (1.6%),P <0.01 ].By Cox analysis,Cornell-QRS standard and Sokolow-Lyon voltage were respectively independent predictors to non-fatal myocardial infarction and also stroke.Conclusion Cornell-QRS stand-ard and Sokolow-Lyon voltage may be independent predictors to main cardiovascular accident in hypertensive patients.