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[接受不同降压治疗的高血压患者正交心电图的变化]

[Changes in orthogonal ECG in hypertensive patients taking different antihypertensive therapy].

作者信息

Sakhnova T A, Blinova E V, Riabykina G V, Shutova L I, Chikhladze N M, Martyniuk T V, Chazova I E

出版信息

Ter Arkh. 2011;83(4):39-42.

Abstract

AIM

To ascertain changes in orthogonal ECG in hypertensive patients taking different antihypertensive treatment.

MATERIAL AND METHODS

Orthogonal ECG parameters and those of 24-h blood pressure monitoring (BPM) were examined before and after antihypertensive treatment with different drugs in 95 hypertensive patients aged 47 +/- 1 years. Of them, 14 patients received trandolapril+verapamil SR for 2 months, 13 patients--candesartan for 3 months, 25 patients--ramipril for 5 months, 26 patients--carvedilol for 4 months, 10 patients--atenolol for 8 months, 7 patients--doxasozine for 5 months.

RESULTS

24-h BPM parameters improved in all the groups. Initially, conventional ECG evidence on left ventricular hypertrophy was not seen in 86% patients. Dynamics of orthogonal ECG showed that parameters which increase in left ventricular hypertrophy decrease in response to treatment in patients with baseline values above the median. Parameters G and Gx, which in left ventricular hypertrophy diminish, rise significantly in patients with baseline values under median due to therapy. Treatment with impact on renin-angiotensin system reduced voltage parameters of orthogonal ECG, improved G characterizing repolarisation. Treatment with adrenoreceptors blockers reduced IADI.

CONCLUSION

The analysis of parameters of orthogonal ECG reveals positive dynamics in response to treatment in patients with insignificant changes on ECG in short follow-up. Drugs of different groups change different parameters of orthogonal ECG.

摘要

目的

确定服用不同抗高血压药物的高血压患者正交心电图的变化。

材料与方法

对95例年龄为47±1岁的高血压患者在使用不同药物进行抗高血压治疗前后的正交心电图参数和24小时血压监测(BPM)参数进行检测。其中,14例患者接受群多普利+缓释维拉帕米治疗2个月,13例患者接受坎地沙坦治疗3个月,25例患者接受雷米普利治疗5个月,26例患者接受卡维地洛治疗4个月,10例患者接受阿替洛尔治疗8个月,7例患者接受多沙唑嗪治疗5个月。

结果

所有组的24小时BPM参数均有所改善。最初,86%的患者未出现左心室肥厚的常规心电图证据。正交心电图动态显示,对于基线值高于中位数的患者,左心室肥厚时增加的参数在治疗后降低。对于基线值低于中位数的患者,由于治疗,左心室肥厚时降低的参数G和Gx显著升高。对肾素-血管紧张素系统有影响的治疗降低了正交心电图的电压参数,改善了表征复极化的G参数。使用肾上腺素能受体阻滞剂治疗降低了IADI。

结论

对正交心电图参数的分析显示,在短期随访中心电图变化不明显的患者在治疗后呈现出积极的动态变化。不同组的药物改变正交心电图的不同参数。

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