论文部分内容阅读
目的探讨原发性高血压患者心率变异性与动脉硬化的相关性。方法 200例原发性高血压患者按其脉搏波传导速度(pulse wave velocity,PWV)分为PWV升高组(≥9m/s)和PWV正常组(<9m/s)各100例。监测2组患者24h心电图和动态血压,观察并比较2组心率变异性的相关性指标。结果 PWV升高组5min心搏R-R间期平均值的标准差[(156.78±10.53)ms]低于PWV正常组[(189.79±13.70)ms],低频(low frequency,LF)值[(700.72±91.41)Hz]、高频(high frequency,HF)值[(852.00±94.78)Hz]以及LF/HF比值(1.03±0.32)较PWV正常组[(350.68±78.83)Hz、(500.21±55.73)Hz、0.84±0.22]升高(P均<0.05),24h心搏R-R间期平均值的标准差[(88.89±8.79)ms]与PWV正常组[(89.66±8.62)ms]比较差异无统计学意义(P>0.05);PWV升高组24h收缩压[(149.57±22.67)mm Hg]、脉压[(59.32±10.79)mm Hg]高于PWV正常组[(133.58±21.43)mm Hg、(47.31±9.83)mm Hg](P<0.05),但24h舒张压[(82.68±15.23)mm Hg]与PWV正常组[(81.47±14.58)mm Hg]比较差异无统计学意义(P>0.05);PWV升高组日间收缩压[(151.38±11.36)mm Hg]、夜间收缩压[(137.72±12.63)mm Hg]、日间脉压[(57.82±4.67)mm Hg]、夜间脉压[(53.71±4.12)mm Hg]均高于PWV正常组[(140.25±20.79)、(124.39±10.62)mm Hg,(48.99±4.39)、(42.66±4.02)mm Hg],差异有统计学意义(P<0.05)。结论 PWV和心率变异性是评价动脉硬化和自主神经功能受损的重要指标,心率变异性增加可降低原发性高血压患者的血压调节能力,加重血管损害。
Objective To investigate the correlation between heart rate variability and arteriosclerosis in patients with essential hypertension. Methods 200 patients with essential hypertension were divided into PWV group (≥9m / s) and PWV group (n = 100) by pulse wave velocity (PWV). The electrocardiogram and ambulatory blood pressure were monitored 24hours in both groups, and the relative indexes of heart rate variability in the two groups were observed and compared. Results The standard deviation of mean RR interval was higher in PWV elevation group than that in normal PWV group [(156.78 ± 10.53) ms [(189.79 ± 13.70) ms] and low frequency (LF [700.72 ± 91.41) Hz, HF (852.00 ± 94.78) Hz and LF / HF (1.03 ± 0.32) were significantly higher than those in normal PWV group (350.68 ± 78.83 Hz and 500.21 ± 55.73 Hz, respectively) , 0.84 ± 0.22] (all P <0.05). The standard deviation of the mean RR interval of 24h heart rate [(88.89 ± 8.79) ms] compared with the normal PWV group [(89.66 ± 8.62) ms] showed no significant difference (P <0.05). The systolic blood pressure (149.57 ± 22.67 mm Hg) and pulse pressure (59.32 ± 10.79 mm Hg) in the PWV increased group were higher than those in the PWV normal group (133.58 ± 21.43 mm Hg, 47.31 ± 9.83 mmHg] (P <0.05), but no significant difference was found between 24h diastolic pressure (82.68 ± 15.23) mmHg and normal PWV group (81.47 ± 14.58 mmHg) (151.38 ± 11.36) mm Hg], nocturnal systolic pressure (137.72 ± 12.63) mm Hg, daytime pulse pressure (57.82 ± 4.67) mm Hg, nocturnal pulse pressure [ (53.71 ± 4.12) mm Hg] were significantly higher than those in the normal PWV group [(140.25 ± 20.79), (124.39 ± 10.62) mm Hg, (48.99 ± 4.39) and (42.66 ± 4.02) mm Hg, respectively] P <0.05)Conclusions PWV and heart rate variability are important indexes for evaluating arteriosclerosis and impaired autonomic nerve function. Increased heart rate variability can reduce the blood pressure regulating ability of patients with essential hypertension and aggravate the vascular damage.