[1]黄静涵 樊晓寒 刘方 廖中凯 黄洁 郑哲.心脏移植术后患者心电图、动态血压监测结果特征分析[J].心血管病学进展,2025,(3):258.[doi:10.16806/j.cnki.issn.1004-3934.2025.03.015]
　HUANG Jinghan,FAN Xiaohan,LIU Fang,et al.Characteristic Analysis of Electrocardiogram and Dynamic Blood Pressure Monitoring Results in Patients After Heart Transplantation[J].Advances in Cardiovascular Diseases,2025,(3):258.[doi:10.16806/j.cnki.issn.1004-3934.2025.03.015]
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心脏移植术后患者心电图、动态血压监测结果特征分析()
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《心血管病学进展》[ISSN:51-1187/R/CN:1004-3934]

卷:
期数:
2025年3期
页码:
258
栏目:
论著
出版日期:
2025-03-25

文章信息/Info

Title:
Characteristic Analysis of Electrocardiogram and Dynamic Blood Pressure Monitoring Results in Patients After Heart Transplantation
作者:
黄静涵1 樊晓寒 1 刘方 1 廖中凯 2 黄洁 2 郑哲 3
(1.中国医学科学院 北京协和医学院 国家心血管病中心 阜外医院功能检测科,北京 100037;2.中国医学科学院 北京协和医学院 国家心血管病中心 阜外医院心力衰竭与移植病区,北京 100037;3.中国医学科学院 北京协和医学院 国家心血管病中心 阜外医院成人外科中心,北京 100037)
Author(s):
HUANG Jinghan1;  FAN Xiaohan1;  LIU Fang1; LIAO Zhongkai2;  HUANG Jie2; ZHENG Zhe3
(1.Heart Function Testing Center, National Center for Cardiovascular Diseases and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China; 2. Heart Failure and Heart Transplant Ward, National Center for Cardiovascular Diseases and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China; 3. Adult Cardiac Surgery Center, National Center for Cardiovascular Diseases and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China)
关键词:
心电图; 动态血压监测; 心脏移植
Keywords:
Electrocardiogram;  Dynamic blood pressure monitoring;  Heart transplant
DOI:
10.16806/j.cnki.issn.1004-3934.2025.03.015
摘要:
目的 分析心脏移植术后心脏去神经化患者心电图、动态血压监测变化特征。方法 回顾分析中国医学科学院阜外医院心脏移植术后患者60例，比较移植前后心电图、血压变化特点；随机选60例正常人群和60例高血压患者作为对照组，比较三组随访血压心率监测结果。结果 三组性别、年龄均无统计学差异。移植术后窦性心律比例、射血分数、收缩压、舒张压及心率均显著高于术前；心房颤动发生比例、起搏器植入比例显著降低。移植组平均心率、QRS波群宽度、右束支传导阻滞比例显著高于正常对照组。移植组全天及白天收缩压和舒张压均显著低于高血压组，与正常对照组无差异；移植组夜间收缩压、舒张压均显著高于正常对照组，与高血压组无差异。移植组血压呈反杓型+非杓型比例显著升高，夜间血压及心率下降程度均显著低于正常对照组和高血压组，血压下降幅度小于心率下降幅度。移植组无创心电自主神经功能指标心率变异性、心率减速力显著低于正常对照组和高血压组，肾功能指标显著升高。Logistic回归分析结果显示女性、移植前高血压、肾功能下降增加高血压风险，Pearson相关分析显示肾功能与夜间血压、心率下降程度相关。结论 移植组血压和心率呈现昼夜节律减弱、夜间血压高心率快的特点，夜间血压下降幅度小于心率下降幅度，自主神经功能、肾功能显著下降，女性、移植前高血压、肾功能下降增加高血压风险。
Abstract:
Objective To analyze the characteristics of electrocardiogram and dynamic blood pressure monitoring results in patients with cardiac denervation after heart transplantation. Methods 60 patients after heart transplantation at Fuwai Hospital were reviewed. The characteristics of electrocardiogram and blood pressure changes before and after transplantation were compared. 60 normal patients and 60 hypertensive patients were randomly selected as the control group, and the results of blood pressure and heart rate monitoring were compared among the three groups. Results There were no statistically significant differences in gender and age among the three group s. After transplantation, the proportion of sinus rhythm, ejection fraction, blood pressure and heart rate were significantly higher than before surgery. The incidence of atrial fibrillation and the proportion of pacemaker implantation have significantly decreased. The average of heart rate,QRS wave width and right -bundle branch block ratio in the transplantation were significantly higher than those in the normal group. The all day blood pressure of transplantation group and normal group was significantly lower than hypertension group . The nighttime blood pressure in transplantation group and hypertension group was significantly higher than normal control group. The transplantation group showed a significant increase in the proportion of anti-spoon and non-spoon blood pressure types, and the decrease in nighttime blood pressure and heart rate was significantly lower than normal and hypertension groups. The nighttime decrease in blood pressure was smaller than that in heart rate. The non-invasive electrocardiogram autonomic nervous system function indicators, includingheart rate variability and deceleration capacity of heart rate, were significantly lower in the transplantation group than in the normal and hypertension groups. The renal function indicators in the transplantation group were significantly increased. The results of logistic regression analysis showed that women, pre-transplant hypertension, and decreased renal function increased the risk of hypertension. Pearson correlation analysis showed that renal function was related to the degree of nighttime blood pressure and heart rate decrease. Conclusion The blood pressure and heart rate of the transplantation group showed a weakened circadian rhythm, high nighttime blood pressure, and fast heart rate. The decrease in nighttime blood pressure was smaller than the decrease in heart rate, and the autonomic nervous system and renal function significantly decreased. Women with pre-transplant hypertension and decreased renal function increased the risk of hypertension

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更新日期/Last Update: 2025-04-29