高血压合并2型糖尿病患者心率震荡的研究  

Analysis of the sinus heart rate turbulence and resting heart rate in patients with hypertension and type 2 diabetes mellitus

作　　者：陈青萍[1] 黄学成[1] 邓梓谦[1] 张凤玲[1] 黄宁[1] 陈颖[1] 

机构地区：[1]广西医科大学第三附属医院,530031

出　　处：《临床心电学杂志》2010年第1期29-32,共4页Journal of Clinical Electrocardiology

摘　　要：目的探讨窦性心率震荡(HRT)、静息心率(RHR)和心率变异性(HRV)时阈指标(SDNN)在单纯高血压及高血压合并2型糖尿病中的变化及相互关系。方法选择单纯高血压46例、高血压合并2型糖尿病22例和健康人50例,分别为单纯高血压组、高血压合并2型糖尿病组和对照组。根据24h动态心电图记录,分别计算各组HRT的两个参数震荡初始值(TO)和震荡斜率值(TS)以及HRV的全部NN间期的标准差(SDNN)和6:00时的RHR,比较各组间的差别,分析TO、TS与SDNN、RHR之间的相关性。结果高血压合并2型糖尿病组TO、TS、TO+TS、SDNN的阳性检出率均高于单纯高血压组及对照组,组间比较差异有显著意义;RHR值明显高于单纯高血压组及对照组,组间比较差异有显著意义。高血压合并2型糖尿病组TO与SDNN呈负相关,与RHR呈正相关;TS与RHR呈负相关,而与SDNN呈正相关。结论高血压患者特别是合并有2型糖尿病者,HRT减弱及HRV异常,RHR增加,提示HRT及RHR可以作为早期发现高血压或合并2型糖尿病患者心脏自主神经功能紊乱的一个有效的可靠无创指标。Objective To compare the sinus heart rate turbulence（HRT）, resting heart rate（RHR）and normal-to-normal RR intervals （SDNN） standard deviation of heart rate variability （HRV） in simple hypertension and hypertension with type 2 diabetes, and to study the relation of these indexes. Methods 24h dynamic electro-cardiograms were recorded in 46 patients with simple hypertension （simple hypertension group）,22 patients with hypertension and type 2 diabetes （hypertension and type 2 diabetes group） and 50 healthy persons （control group）, then the SDNN and the HRT of each group of 6：00 Am, turbulence onset（TO） and turbulence slope（TS） were measured and the relation of these indexes was analyzed. Results The positive detection rate of the TO, TS, TO＋TS, SDNN of patients with hypertension and type 2 diabetes were higher than the other two groups, the group comparison had significant difference. In patients with hypertension and type 2 diabetes, there was negative correlation between TO and SDNN, TS and RHR, as well as positive correlation between TO and RHR, TS and SDNN. Conclusions HRT and RHR maybe a validly way to discover the hearts autonomic neuropathy in patients with hypertension and type 2 diabetes or simple hypertension.

关 键 词：高血压 2型糖尿病 窦性心率震荡 

分 类 号：R544.1[医药卫生—心血管疾病] R587.1[医药卫生—内科学]