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目的探讨无症状心肌缺血患者的动态血压及室性心律失常特点。方法回顾性分析74例高血压合并无症状心肌缺血的冠心痛患者同时行动态血压及动态心电图监测的临床资料,其中缺血型ST段下移组23例(A组),无ST段偏移组51例(B组),研究2组间的血压及室性心律失常变化。结果A组的24 h收缩压、白天收缩压及夜间收缩压显著高于B组,差异有统计学意义(均P<0.01);24 h舒张压、白天舒张压及夜间舒张压显著高于B组,差异有统计学意义(均P<0.01)。B组的室性期前收缩数目比A组显著增加,差异有统计学意义(P<0.01);Lown分级Ⅲ级以上的室性心律失常在A组的发生率为39.1%,B组发生率为9.8%,2组比较差异有统计学意义(P<0.05)。结论无症状心肌缺血患者的动态血压指标升高,室性期前收缩数目虽然不增加,但Lown分级Ⅲ级以上的室性心律失常发生率上升。
Objective To investigate the characteristics of ambulatory blood pressure and ventricular arrhythmia in asymptomatic patients with myocardial ischemia. Methods The clinical data of 74 patients with coronary heart disease complicated with asymptomatic myocardial ischemia treated with ambulatory blood pressure and ambulatory electrocardiogram monitoring were retrospectively analyzed. Twenty - three patients (group A) with ischemic ST - Totally 51 patients (group B) were divided into two groups to study the changes of blood pressure and ventricular arrhythmia. Results The systolic blood pressure at 24 hours, systolic blood pressure at daytime and systolic blood pressure at night in group A were significantly higher than those in group B (all P <0.01). The diastolic blood pressure, daytime diastolic blood pressure and diastolic blood pressure at night in group A were significantly higher than those in group B Group, the difference was statistically significant (all P <0.01). The number of premature ventricular contractions in group B was significantly higher than that in group A (P <0.01). The incidence of ventricular arrhythmias with Lown grade Ⅲ or higher was 39.1% in group A, and the incidence of group B 9.8%, the difference between the two groups was statistically significant (P <0.05). Conclusion The index of ambulatory blood pressure in patients with asymptomatic myocardial ischemia increased, while the number of premature ventricular contractions did not increase, but the incidence of ventricular arrhythmias with Lown grade Ⅲ or higher increased.