高血压患者血压昼夜节律与心肌缺血心律失常的关系

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(P0.05)。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。

Relationship of Circadian Rhythms of Blood Pressure in Patients with Hypertension and Myocardial Ischemia Arrhythmia

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.