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目的探讨高龄高血压患者窦性心律震荡(heart rate turbulence,HRT)现象及其临床意义。方法选择高龄高血压患者52例,同期健康体检者60例。除做常规化验及检查外,做24h动态心电图及动态血压监测,测量窦性心律震荡参数:震荡初始(turbulence onset,TO)的均值,震荡斜率(turbulence slope,TS)的均值及心率变异参数窦性心率RR间期的标准差(SDNN)。结果高龄高血压患者TO(3.21±2.01)明显高于正常对照组(-2.24±2.41),差异有统计学意义(P<0.01);TS值明显小于对照组(分别为7.0±3.6,11.7±6.1),差异有统计学意义(P<0.01)。SDNN与TO呈负相关,与TS呈正相关,TO、TS无相关性。结论高龄高血压患者的HRT明显减弱,说明其自主神经功能受损严重。
Objective To investigate the incidence of heart rate turbulence (HRT) in elderly patients with hypertension and its clinical significance. Methods 52 cases of elderly patients with hypertension, 60 cases of physical examination over the same period. In addition to routine laboratory tests and examinations, 24-hour ambulatory electrocardiogram and ambulatory blood pressure monitoring were performed to measure sinus rhythm parameters: mean of turbulence onset (TO), mean of mean turbulence slope (TS) and sinus parameter Sexual Heart Rate RR interval standard deviation (SDNN). Results The TO (3.21 ± 2.01) in elderly hypertensive patients was significantly higher than that in normal controls (-2.24 ± 2.41), the difference was statistically significant (P <0.01); the TS value was significantly lower than that in control group (7.0 ± 3.6, 6.1), the difference was statistically significant (P <0.01). SDNN was negatively correlated with TO, positively correlated with TS, and had no correlation with TO and TS. Conclusion HRT in elderly patients with hypertension significantly decreased, indicating severe autonomic dysfunction.