糖、脂代谢异常对老年男性高血压患者心率变异性的影响  

The Effects of Impaired Glucose Metabolism and Impaired Blood Lipoprotein Metabolism on Heart Rate Variability in Hypertension Patients

作　　者：王煜[1] 邓洁[1] 李轶炜 孙凌[1] 王瑞萍[1] 

机构地区：[1]云南省昆明市延安医院干部科干三病区,650051

出　　处：《医学研究杂志》2009年第1期46-49,共4页Journal of Medical Research

摘　　要：目的本研究旨在探索糖、脂代谢异常对老年男性高血压患者心率变异性(HRV)的影响,并且观察糖代谢异常年限与其HRV的关系。方法入选人群为120例老年男性,其中单纯高血压组(A组)40例、高血压合并糖尿病组(B组)40例、高血压合并糖、脂代谢异常组(C组)40例,共3组。分别对其进行24小时动态心电图,收集其HRV时域指标,之后进行对比分析,了解糖、脂代谢异常对高血压患者HRV产生的影响。在高血压合并糖、脂代谢异常组中按总胆固醇(TC)<5.72mmol/L及TC≥5.72mmol/L分为非高胆固醇组及高胆固醇组两亚组,分析此两亚组HRV的差异。高血压合并糖尿病组按糖尿病患病年限分为<5年、5～10年、≥10年3亚组,分析3组间HRV的差异,了解糖尿病患病年限与其HRV的关系。结果(1)与单纯高血压组相比,高血压合并糖尿病组、高血压合并糖、脂代谢异常组HRV时域指标减少(P<0.05);与高血压合并糖尿病组相比,高血压合并糖、脂代谢异常组HRV时域指标减少(P<0.05)。(2)高胆固醇组较非高胆固醇组HRV时域指标减少(P<0.05)。(3)高血压合并糖尿病组患者随着其糖尿病病程增长,HRV时域指标降低(P<0.05)。结论(1)高血压合并糖尿病组较单纯高血压组的HRV明显降低,提示糖代谢异常可能使高血压患者自主神经功能更加紊乱。(2)高血压合并糖、脂代谢异常组较高血压合并糖尿病组HRV降低,高胆固醇组较非高胆固醇组HRV减少,提示脂代谢异常可能加重高血压患者自主神经功能紊乱,胆固醇升高可能是其原因之一。(3)随着糖尿病患病年限的延长,高血压患者HRV进一步降低,提示随着糖尿病患病年限延长,高血压患者自主神经功能紊乱程度增加。Objective To explore the effects of impaired glucose metabolism and impaired blood lipoprotein metabolism on heart rate variability（HRV） in aged male hypertension patients and to have an insight into the correlation between the years of impaired glucose me- tabolism and the patients＇ HRV. Methods 120 male subjects were divided into three groups： simple hypertension patients （group A, 40 people）, hypertension patients with diabetes mellitus （group B, 40 people）, and hypertension patients with diabetes mellitus and im- paired blood lipoprotein metabolism （group C, 40 people）. All subjects had 24h recordings of ECG. The data of HRV time domain were collected and analyzed to gain an insight into the effects of the impaired glucose metabolism and impaired blood lipoprotein metabolism on patients＇ HRV. In group C, patients were divided into normal TC subgroup and high TC subgroup according to the index of TC （TC 〈 5.72mmol/L and TC/〉 5.72retool/L）. The differences of HRV between these two subgroups were analyzed. Among group B, subjects were divided into three subgroups by their years of diseases as 〈 5 years, 5 - 10years, and i〉 10years. The differences of HRV among these three subgroups were analyzed and the correlation of the years of disease with the HRV was revealed through the statistic analysis. Results （1） compared with group A, group B and group C had a decrease in HRV time domain （P 〈 0.05） ; compared with group B, group C had a decrease in HRV time domain （P〈0.05）. （2）The high TC group had adecrease in HRV time domain （P〈0.05） com- pared with the normal group. （3） The group B had a decrease in HRV time domain （ P 〈 0.05 ） with the process of the disease. Conclu- sion （1）Compared with group A,group B has an evident decrease in HRV, which indicates that the impaired glucose metabolism may lead to the more serious disorder of automatic nervous system. （2） Compared with group B, group C has a decrease in HRV; high TC group has a decrea

关 键 词：高血压 糖尿病 高胆固醇血症 心率变异性 

分 类 号：R544.1[医药卫生—心血管疾病] R714.256[医药卫生—内科学]