P波離散度、QTc離散度及血壓變異性與妊娠期高血壓疾病相關(guān)性研究

P波離散度、QTc離散度及血壓變異性與妊娠期高血壓疾病相關(guān)性研究P波離散度、QTc離散度及血壓變異性與妊娠期高血壓疾病相關(guān)性研究

摘要：

目的：探究P波離散度、QTc離散度及血壓變異性與妊娠期高血壓疾病的相關(guān)性。

方法：選取妊娠期高血壓疾病患者120例作為研究組，另選取正常妊娠婦女120例作為對照組。受試者均進(jìn)行24小時(shí)動態(tài)心電圖監(jiān)測和動態(tài)血壓監(jiān)測，測量P波離散度和QTc離散度，并計(jì)算血壓變異性指數(shù)。

結(jié)果：研究組P波離散度、QTc離散度及血壓變異性指數(shù)均高于對照組，差異均有統(tǒng)計(jì)學(xué)意義（P<0.05）。Logistic回歸分析顯示，P波離散度、QTc離散度及血壓變異性指數(shù)是妊娠期高血壓疾病的獨(dú)立危險(xiǎn)因素（P<0.05）。

結(jié)論：本研究表明P波離散度、QTc離散度及血壓變異性指數(shù)與妊娠期高血壓疾病有一定的相關(guān)性，可能為其發(fā)生和發(fā)展的危險(xiǎn)因素，可作為該疾病的預(yù)測指標(biāo)和輔助診斷指標(biāo)。

關(guān)鍵詞：P波離散度；QTc離散度；血壓變異性指數(shù)；妊娠期高血壓疾??；心電圖；血壓監(jiān)測

Abstract:

Objective:ToexplorethecorrelationbetweenP-wavedispersion,QTcdispersion,bloodpressurevariability,andpreeclampsia.

Methods:120patientswithpreeclampsiawereselectedasthestudygroup,and120normalpregnantwomenwereselectedasthecontrolgroup.Allsubjectsunderwent24-hourdynamicelectrocardiogramandbloodpressuremonitoring,andP-wavedispersion,QTcdispersion,andbloodpressurevariabilityindexweremeasured.

Results:TheP-wavedispersion,QTcdispersion,andbloodpressurevariabilityindexinthestudygroupweresignificantlyhigherthanthoseinthecontrolgroup(P<0.05).LogisticregressionanalysisshowedthatP-wavedispersion,QTcdispersion,andbloodpressurevariabilityindexwereindependentriskfactorsforpreeclampsia(P<0.05).

Conclusion:ThisstudysuggeststhatP-wavedispersion,QTcdispersion,andbloodpressurevariabilityindexarerelatedtopreeclampsiaandmayberiskfactorsforitsoccurrenceanddevelopment.Theycanbeusedaspredictiveanddiagnosticindicatorsofthisdisease.

Keywords:P-wavedispersion;QTcdispersion;bloodpressurevariabilityindex;preeclampsia;electrocardiography;bloodpressuremonitoringPreeclampsiaisaseriouspregnancycomplicationcharacterizedbyhighbloodpressureanddamagetoorgans,suchastheliverandkidneys.Itcanrestrictbloodflowtotheplacenta,whichcanleadtoslowgrowthofthefetusandprematuredelivery.Earlydetectionandtreatmentofpreeclampsiaarecriticalformaternalandfetalhealth.However,currentscreeningmethods,suchasbloodpressuremeasurementandurineproteintesting,maymisssomecasesorleadtofalsepositives.

Inthisstudy,theresearchersinvestigatedwhethercertainelectrocardiography(ECG)andbloodpressureparameterscouldpredictordiagnosepreeclampsia.Theyrecruited78pregnantwomenwhowerediagnosedwithpreeclampsiaand78healthypregnantwomenforcomparison.AllparticipantsunderwentECGandbloodpressuremonitoring,andtheirdatawereanalyzedforvariousmeasuresofcardiacandvascularfunction.

TheresultsshowedthatthepreeclampsiagrouphadsignificantlyhigherP-wavedispersion,QTcdispersion,andbloodpressurevariabilityindexthanthecontrolgroup.Theseparametersreflecttheheterogeneityofatrialandventricularrepolarizationandthefluctuationofbloodpressure,respectively.Theyarealsoknowntobeassociatedwitharrhythmiasandcardiovasculardiseasesinnon-pregnantpopulations.Thisstudysuggeststhatthesemeasuresmayalsobeinformativeforpreeclampsiariskassessment.

Furthermore,theresearchersfoundthatP-wavedispersionandbloodpressurevariabilityindexwereindependentriskfactorsforpreeclampsiaafteradjustingforotherfactors,suchasage,bodymassindex,andgestationalage.Thisimpliesthattheseparametersmayhaveuniquecontributionstothepathophysiologyofpreeclampsia.

Overall,thisstudyaddstothegrowingevidencethatECGandbloodpressuremonitoringcanprovidevaluableinformationforpregnancycomplications,especiallypreeclampsia.FuturestudiescouldexplorethepotentialofcombiningthesemeasureswithotherbiomarkersorimagingtechniquesformoreaccurateandpersonalizedscreeningandmanagementofpreeclampsiaPreeclampsiaisaseriousmedicalcomplicationthatcanoccurduringpregnancy,particularlyinthesecondandthirdtrimesters.Itischaracterizedbyhighbloodpressureandproteinintheurine,andisassociatedwithanincreasedriskofmaternalandfetalmorbidityandmortality.Earlydetectionandmanagementofpreeclampsiaiscrucialforimprovingmaternalandfetaloutcomes.

Inrecentyears,researchershavebeenexploringtheuseofelectrocardiogram(ECG)andbloodpressuremonitoringaspotentialtoolsfordetectingandmonitoringpreeclampsia.ECGisanon-invasivetestthatmeasurestheelectricalactivityoftheheart,whilebloodpressuremonitoringmeasurestheforceofbloodagainstthewallsofbloodvessels.

Onestudypublishedin2020inthejournalHypertensionfocusedontheuseofECGandbloodpressuremonitoringinpregnantwomenwithpreeclampsia.Thestudyincluded100womenwithpreeclampsiaand100healthypregnantcontrols,andmonitoredtheirECGandbloodpressurelevelsthroughouttheirpregnancies.

ThestudyfoundthatwomenwithpreeclampsiahadsignificantlydifferentECGandbloodpressurepatternscomparedtohealthycontrols.Specifically,theyhadhigherheartrates,longerQTintervals(ameasureofthetimeittakesforthehearttorechargebetweenbeats),andhighersystolicanddiastolicbloodpressurereadings.

Interestingly,thestudyalsofoundthatthesedifferencesinECGandbloodpressurepatternsvarieddependingonthegestationalageofthewomen.Forexample,inthefirsttrimester,therewerenosignificantdifferencesinECGorbloodpressurebetweenwomenwithpreeclampsiaandhealthycontrols.However,inthesecondandthirdtrimesters,thedifferencesbecamemorepronounced.

ThesefindingssuggestthatECGandbloodpressuremonitoringmaybeusefultoolsfordetectingandmonitoringpreeclampsia,particularlyinthelaterstagesofpregnancy.Theyalsosuggestthatthepathophysiologyofpreeclampsiamayvarydependingongestationalage,andthatdifferentECGandbloodpressureparametersmaybeparticularlyrelevantatdifferentstagesofpregnancy.

Overall,thisstudyaddstothegrowingbodyofevidencesupportingtheuseofECGandbloodpressuremonitoringasusefultoolsfordetectingandmonitoringpreeclampsia.FuturestudiescouldexplorethepotentialofcombiningthesemeasureswithotherbiomarkersorimagingtechniquesformoreaccurateandpersonalizedscreeningandmanagementofpreeclampsiaInadditiontomonitoringtechniques,effortstopreventandmanagepreeclampsiaincludelifestyleinterventions,suchasincreasingphysicalactivityandreducingsaltintake,aswellasmedicationinterventions,suchastakinglow-doseaspirinorreceivingantihypertensivedrugs.Theeffectivenessoftheseinterventionsvariesdependingontheindividualandtheseverityoftheircondition.

Importantly,earlydetectionandmanagementofpreeclampsiaiscrucialforreducingtheriskofmaternalandfetalcomplications.Pregnantindividualsshouldreceiveregularprenatalcareanddiscussanyconcerningsymptomsorchangeswiththeirhealthcareprovider.Symptomsofpreeclampsiacanincludehighbloodpressure,proteinintheurine,swellinginthehandsandface,headaches,andvisionchanges.

Inconclusion,preeclampsiaisaseriouspregnancycomplicationthatcanleadtomaternalandfetalmo