老年高血压心肌肥厚患者的室性心律失常与心率变异性  

The Relationship between the Ventricular Arrhythmia and the Heart Rate Variability in the Older Patients with Ventriclar Hypertrophy

作　　者：李小鹰[1] 范利[1] 陈光群[1] 曾青云[1] 

机构地区：[1]解放军总医院老年心内科

出　　处：《高血压杂志》1997年第3期202-204,共3页Chinese Journal of Hypertension

摘　　要：目的了解老年高血压心肌肥厚（ＬＶＨ）患者室性心律失常与心率变异性（ＨＲＶ）的关系。方法２３１例老年（≥６０岁）高血压患者经超声心动图和２４ｈ动态心电图检查测定左室质量指数（ＬＶＭＩ）、左室射血分数（ＬＶＥＦ）、２４ｈ室性早搏总数（ＶＰＣｓ）、Ｌｏｗｎ＇ｓ分级和心率变异指数（ＨＲＶＩ），并采用多元逐步回归法分析ＶＰＣｓ与ＨＲＶＩ、ＬＶＥＦ和ＬＶ－ＭＩ的关系。结果Ｌｏｗｎ＇ｓ３～４级组ＨＲＶＩ减低（≤２５）的发生率和ＨＲＶＩ平均值分别为５１．７％和２０．１±８．９；１～２级组分别为３９．９％和２４．３±７．９（Ｐ＜０．０５）；在ＬＶＨ组为６１．９％和１９．８±９．４，ＮＬＶＨ组为２９．５％和２２．４±７．１（Ｐ＜０．０５）；在ＬＶＥＦ＜５０％组为６７．３％和１８．２±９．８（Ｐ＜０．０５），ＬＶＥＦ≥５０％组为２３．８％和２３．８±１１．８（Ｐ＜０．０１）。元逐步回归分析显示ＶＰＣｓ与ＨＲＶＩ（ｒ＝－０．３１０４，Ｐ＜０．０１）和ＬＶＥＦ（ｒ＝－０．４２１６，Ｐ＜０．００１）呈显著负相关，而与ＬＶＭＩ呈正相关（ｒ＝０．２８４５，Ｐ＜０．００１）。结论老年高血压ＬＶＨ患者的室性心律失常与ＨＲＶＩ和ＬＶＥＦ呈显著负?S\ Aim\ To investigate the relationship between the ventricular arrhythmia and the heart rate variability(HRV) in the elderly patients with left ventriclar hypertrophy(LVH). \ Methods\ Two hundred and thirty one patients(≥60 years) were examined by Holter ECG and UCG to determine left ventricular mass index(LVMI),left ventricular ejection fraction(LVEF), total ventricular premature contractions(VPCs) in 24 hours, Lown's grade and HRV index(HRVI).\ The relationship between VPCs and HRVI was analyzed by stepwise multiple regression(SMR).\ Results\ In Lown's 3￣4 grade the incidence of HRVI decrease(≤25) and mean HRVI were 51 7%,20 1±8 9,in Lown's 1￣2 grade 39 9%,24 3±7 9 (P<0 01,P<0 05);in LVH 61 9%,19 8±9 4 ,in NLVH 29 5%,22 4±7 1 (P<0 01,P<0 05);in LVEF<50% 67 3%,18 2±9 8 ; 23 8%,in LVEF≥50% 23 8±11 8 (P<0 001,P<0 01), respectively.\ The analysis of SMR shows the negative relationships between VPCs and HRVI was r=-0 3104,P<0 01,VPC and LVEFr=-0 4216,P<0 001), and positive correlative corelation between VPCs and LVMI(r=0 2845,P<0 001).\ Conclusion\ The ventricular arrhythmias in the older patients with hypertensive LVH is negatively correlated with HRVI and LVEF,and positively correlated with LVMI.

关 键 词：老年高血压 室性心律失常 心率变异性 高血压 

分 类 号：R544.102[医药卫生—心血管疾病]