目的:探讨高血压患者左室重量指数和相对室壁厚度与心率震荡的关系,以及比索洛尔干预后的变化情况。方法:选择首次确诊并有室性期前收缩的高血压患者82例和非高血压患者对照组78例,并根据是否服用比索洛尔,将高血压患者随机设立基础治疗组为对照组(38例)和比索洛尔治疗组(44例);利用24h动态心电图分析系统获得其室性期前收缩,分别计算治疗前及治疗后4周不同分组的震荡初始(TO)和震荡斜率(TS),同期用心脏超声心动图测定其实验前后左室重量指数(LVMI)和相对室壁厚度(RWT)。结果:高血压患者与非高血压患者比较,其TO降低,TS升高(均P<0.01);线性相关分析显示高血压患者治疗前RWT与TO及TS无显著相关,LVMI与TO呈正相关,与TS呈负相关;治疗4周后高血压患者LVMI和RWT无显著变化,但TO显著降低,TS显著升高,协方差分析显示,扣除治疗前TO和TS的影响后,比较其校正均数,比索洛尔治疗较基础治疗能进一步改善其心率震荡现象,表现为TO显著降低(F=8.68,P<0.05),TS值升高(F=11.32,P<0.05)。结论:高血压患者心率震荡现象与其左室重量指数呈正相关,与相对室壁厚度无相关;短期比索洛尔治疗并不能显著改善左室重构,但可显著改善高血压患者的心率震荡现象。 Objective: To investigate the relationship between left ventricular mass index and relative wall thickness and heart rate turbulence in hypertensive patients and the changes after bisoprolol intervention. Methods: A total of 82 hypertensive patients with first ventricular contractions and 78 patients with nonhypertensive control were enrolled in this study. Based on whether bisoprolol was taken or not, the patients in the essential hypertension group were randomly divided into control group (38) (24 cases) and bisoprolol treatment group (44 cases). The ventricular premature contractions were obtained by 24h electrocardiogram analysis system. The initial oscillatory (TO) and concussion slope (TS) of different groups before and after 4 weeks of treatment were calculated respectively. During the same period, the left ventricular mass index (LVMI) and relative wall thickness (RWT) were measured by echocardiography. Results: Compared with nonhypertensive patients, the levels of TO and TS were significantly increased in hypertensive patients (all P <0.01). The linear correlation analysis showed that there was no significant correlation between RWT, TO and TS before treatment, LVMI and TO, And TS were negatively correlated. There was no significant change in LVMI and RWT in hypertensive patients after 4 weeks of treatment, but TO was significantly decreased and TS was significantly increased. Covariance analysis showed that after adjusting for TO and TS before treatment, Bisoprolol treatment could further improve the heart rate turbulence compared with the basal treatment, showing a significant reduction of TO (F = 8.68, P <0.05) and TS value (F = 11.32, P <0.05). CONCLUSION: Heart rate turbulence in patients with hypertension is positively correlated with left ventricular mass index and has no correlation with relative wall thickness. Short-term bisoprolol treatment does not significantly improve left ventricular remodeling, but can significantly improve heart rate turbulence in hypertensive patients.