高血压病患者ST—T改变与冠心病关系的探讨

目的：探讨高血压病患心心图有ＳＴ－Ｔ改变，伴有不典型胸痛时冠心病的诊断。方法：对７０例心电图有ＳＴ－Ｔ改变，伴有不典型胸痛的高现患有关临床资料与冠脉造影结果进行顾性分析。结果：本资料显示，７０例高血压病患心电图有ＳＴ－Ｔ改变，伴有不典型胸痛时，冠脉造影证实有冠心病占４０％（２８／７０），且以单支和左前降支病变为主。２例证实为心尖肥厚型心肌病。高血压病病程长、血压水平高，冠状动脉２支、３

A Study of the Relationship between Abnormal ST-T in Electrocardiogram and Coronary Heart Disease in Patients of Hypertension

To improve the diagnosis of coronary heart disease in hypertension patients with abnormal ST_T in electrocardiogram (ECG) and atypical chest pain. Methods:The clinical data and coronary arteriography (CAG) results of 70 hypertension patients with abnormal ST_T and atypical chest pain were retrospectively analyzed. Results:Of the 70 cases,40%(28/70) were confirmed by CAG as with coronary disease,and in most cases the involved branches were monobranch and left anterior descending branch. Two cases were proved to be apex hypertrophic cardiomyopathy. In patients with long history of hypertension and very high blood pressure the incidence of combined involvement of two or three coronary branches was more frequent,otherwise the coronary arteries were without abnormality or with only slight abnormality. Conclusion:CAG remains to be a necessary examination for the diagnosis of coronary heartdisease in hypertension patients,because in most cases the abnormal ST_T in ECG and atypical chest pain in hypertension patients do not predict the incidence of coronary disease. When an inverted T wave in ECG was observed,close attention should be paid to the posssibility of hypertrophic cardiomyopahy. The present study indicates that the extent of coronary artery abnormality is associated with the blood pressure level and the duration of disease,which encourages the active prevention and treatment of hypertension to decrease the incidence of coronary heart disease.