Medicine:心电图非特异ST-T改变或可预测血压控制不佳

2017-04-11 朱柳媛 中国循环杂志

中国卒中一级预防试验(CSPPT)的一项最新分析表明,我国约8.5%的高血压患者心电图出现非特异性的ST-T改变,非特异性ST-T改变可能与血压控制不佳有关,在男性患者和糖尿病患者中比较明显。


中国卒中一级预防试验(CSPPT)的一项最新分析表明,我国约8.5%的高血压患者心电图出现非特异性的ST-T改变,非特异性ST-T改变可能与血压控制不佳有关,在男性患者和糖尿病患者中比较明显。

研究者指出,“非特异性ST-T改变可考虑作为血压控制差的早期预测因子。”

他们认为,这项分析结果提示有非特异性ST-T改变的高血压患者需要采取更强的降压措施,尤其男性和糖尿病患者。另外,基层医疗机构应将心电图作为高血压患者的危险筛查工具,这有助于血压控制。

分析结果显示,非特异性ST-T改变在高血压患者中比较常见,其中女性患者和糖尿病患者中更多见,分别占10.3%和13.9%。

研究者发现,近一半(47%)的高血压患者血压控制不达标,而有非特异性ST-T改变的患者中血压控制不达标的比例更高达55.5%。

多因素回归分析表明,非特异性ST-T改变的患者血压控制不佳的可能性增加20%,其中男性患者和糖尿病患者更明显,分别增加51%和47%。

迄今为止,非特异性ST-T改变影响血压控制的具体病生理机制尚不明确。既往研究显示,非特异性ST-T改变可能提示存在亚临床的冠心病、早期左室肥厚、左室质量增加或自主神经功能失调,这些可能会导致血压控制不佳,但需要进一步验证。

近年来的研究表明,高血压患者中非特异性ST-T改变与血管事件和脑血管事件风险增加有关,因此研究者推测血压控制不佳在其中起到“中介”作用。

这项分析从CSPPT中选择了15 038例高血压患者,根据患者基线心电图结果将其分为ST-T不正常组和ST-T正常组。血压控制不佳是指随访4.5年期间高血压患者在应用降压药物的情况下血压仍≥140/90 mmHg。

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    2017-12-22 kalseyzl
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    2017-12-26 jeanqiuqiu
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    2017-04-12 ylzr123

    好文,值得点赞,更值得收藏!慢慢领会学习的。

    0

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