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目的探讨高血压左心室肥厚(LVH)患者T波顶峰后宽度(TpTe间期)的改变及其临床意义。方法随机抽取2010-10-2011-06桂林医学院附属医院心内科住院的原发性高血压(EH)患者313例,根据超声心动图(UCG)测定的左心室质量指数(LVMI)分为LVH组和非LVH(NLVH)组。比较两组TpTe间期、校正TpTe间期(TpTec)、QT间期、校正QT间期(QTc)、QRS时限、LVMI、左心室舒张末期内径(LVEDD)、室间隔厚度(IVST)、左心室后壁厚度(LVPWT)的改变及其相互关系;比较不同血压水平对TpTe间期的影响;EH患者左心室不同构型TpTe间期改变的特点。结果与NLVH组比较,LVH组TpTe间期[(100.0±23.3)比(85.3±14.1)ms]、TpTec[(108.6±26.7)比(91.4±15.4)ms]、QTc[(435.0±23.6)比(420.0±23.5)ms]、QRS时限[(105.3±22.3)比(95.6±16.1)ms]均延长(均P<0.01),LVMI[(142.8±29.3)比(82.5±19.0)g/m2],LVEDD[(58.9±7.5)比(47.6±6.5)cm],IVST[(9.7±1.0)比(8.8±1.2)cm],LVPWT[(9.4±1.1)比(8.5±1.1)cm]明显增大(均P<0.01),QT间期延长,但差异无统计学意义。TpTe间期在不同左心室构型间的改变为:离心型肥厚>向心性肥厚>左心室游离壁肥厚>正常心室形态。Pearson相关分析表明,TpTe间期、TpTec与LVMI(r=0.43,0.44)、LVEDD(r=0.41,0.43)呈正相关(P<0.05)。多元线性回归分析显示,LVMI、LVEDD是TpTe间期重要的影响因素(β=0.026、0.280)。结论 TpTe间期可作为评价高血压伴左心室肥厚靶器官损害程度的心电学指标之一。
Objective To investigate the change of post T wave peak width (TpTe interval) in patients with hypertensive left ventricular hypertrophy (LVH) and its clinical significance. Methods Totally 313 patients with essential hypertension (EH) hospitalized in Department of Cardiology, Affiliated Hospital of Guilin Medical College from October 2010 to November 2011 were divided into three groups according to the left ventricular mass index (LVMI) measured by echocardiography (UCG) Group and non-LVH (NLVH) group. The changes of TpTe interval, QT interval, QTc interval, QRS interval, LVMI, LVEDD, IVST, left ventricular The changes of LVPWT and their correlations were compared. The effects of different blood pressure levels on the TpTe interphase and the changes of TpTe interphase in different configurations of left ventricular in patients with EH were compared. Results Compared with NLVH group, TpTe interval [(100.0 ± 23.3) vs (85.3 ± 14.1) ms], TpTec [(108.6 ± 26.7) vs 91.4 ± 15.4 ms], QTc [(435.0 ± 23.6) (420.0 ± 23.5) ms and LVMI [(142.8 ± 29.3) vs (82.5 ± 19.0) g / m 2, respectively] , LVEDD [(58.9 ± 7.5) vs (47.6 ± 6.5) cm], IVST [(9.7 ± 1.0) vs (8.8 ± 1.2) cm] and LVPWT [(9.4 ± 1.1) vs (8.5 ± 1.1) cm] (All P <0.01), QT interval prolonged, but the difference was not statistically significant. TpTe interphase changes in different left ventricular configuration: Centrifugal hypertrophy> concentric hypertrophy> left ventricular free wall hypertrophy> normal ventricular morphology. Pearson correlation analysis showed that TpTe interval, TpTec and LVMI (r = 0.43,0.44), LVEDD (r = 0.41,0.43) was positively correlated (P <0.05). Multiple linear regression analysis showed that LVMI and LVEDD were the important influential factors of TpTe interphase (β = 0.026, 0.280). Conclusion TpTe interphase can be used as one of the indexes to evaluate the degree of target organ damage in hypertensive patients with left ventricular hypertrophy.