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目的探讨Ⅱ型心肾综合征病人高血压与心率变异性(HRV)的关系,了解高血压对Ⅱ型心肾综合征病人自主神经功能的影响。方法纳入2012年1月—2014年6月中国中医科学院广安门医院心内科的Ⅱ型心肾综合征病人,共187例,按其有无高血压分为高血压组(n=105)及血压正常组(n=82),采用MIC-12H型三导同步全信息动态心电图系统记录各组病人的HRV数据,比较两组病人间HRV的时域指标,相邻间期差值50 ms占总RR间期数的百分比(PNN50)、相邻RR间期差值的均方根(RMSSD)、RR间期平均值的标准差(SDANN)、RR间期总体标准差(SDNN)。结果高血压组病人PNN50、RMSSD、SDANN、SDNN均低于血压正常组,具有统计学意义(P<0.05),其中RMSSD、SDANN有极显著性统计学意义(P<0.01)。相关性分析:HRV、SDANN、SDNN与心功能分级具有负相关性,而PNN50、RMSSD与心功能分级无相关性。结论Ⅱ型心肾综合征伴有高血压病人自主神经功能受损较重,且随着心功能分级的增加,自主神经功能受损越严重。
Objective To investigate the relationship between hypertension and heart rate variability (HRV) in patients with type Ⅱ cardio-renal syndrome and to understand the effect of hypertension on autonomic nervous system function in patients with type Ⅱ cardio-renal syndrome. Methods One hundred and eighty-seven patients with type ⅡXDH admitted to the Department of Cardiology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences from January 2012 to June 2014 were divided into hypertension group (n = 105) and blood pressure In the normal group (n = 82), the HRV data of each group were recorded by MIC-12H three-lead synchronous Holter monitoring system. The time domain index of HRV was compared between the two groups. The difference of adjacent interval was 50 ms Percentage of RR interval (PNN50), root mean square (RMSSD) of RR interval difference, SDANN of RR interval average, and SDNN of RR interval. Results The PNN50, RMSSD, SDANN and SDNN of hypertensive patients were significantly lower than those of normal blood pressure patients (P <0.05). RMSSD and SDANN were significantly different (P <0.01). Correlation analysis: HRV, SDANN, SDNN had a negative correlation with cardiac function classification, but PNN50, RMSSD had no correlation with cardiac function classification. Conclusion Patients with type Ⅱ heart-kidney syndrome complicated with hypertension have impaired autonomic function. And with the increase of cardiac function, autonomic dysfunction is more serious.