老年男性代谢综合征患者心率变异与左心室结构的关系  

Association between heart rate variability and left ventricular structure in elderly patients with metabolic syndrome

作　　者：梁伟[1] 赵雅洁[1] 沈琳辉[1] 张凤如[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院老年病科,200025

出　　处：《中华老年心脑血管病杂志》2012年第2期135-137,共3页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的探讨老年男性代谢综合征(MS)患者心率变异与左心室结构的关系。方法选取老年男性191例,分为MS合并高血压组(HMS组)70例,MS组65例,非MS组56例。测定各组血脂、空腹血糖、空腹胰岛素水平,测量身高、体重、腰围、血压,并行动态心电图监测及超声心动图检查。结果与非MS组比较,HMS组和MS组患者心率变异各项指标参数均明显下降,左心室重量、左心室重量指数、左心室后壁厚度明显增加(P<0.05,P<0.01),HMS组较MS组下降更明显(P<0.05)。HMS组和MS组胰岛素抵抗指数与左心室重量指数呈正相关(r=0.478,P<0.01;r=0.412,P<0.01),与标准差平均值指数呈负相关(r=-0.363,P<0.01;r=0.296,P<0.01)。结论老年男性代谢因素对自主神经功能有影响。高血压合并MS患者代谢因素与血流动力学因素一样也可导致左心室重构。胰岛素抵抗是影响左心室重构的独立危险因素。Objective To explore the relationship between heart rate variability （HRV） and left ventricular structure in elderly patients with metabolic syndrome. Methods 191 men aged 60--90 were divided into three groups： Hypertensive MS group（HMS group）,70 cases;MS group（65 ca- ses） and non-MS group（56 cases）. Serum concentrations of lipids, fasting glucose, fasting insulin were measured. Body height, weight, waist circumference, blood pressure were assessed. All pa- tients were observed by ech0cardiography. 24 h Holter recording and heart rate variability analysis were performed. Results The HRV index were markedly lower in HMS and MS group than in non-MS group（P〈0.05,P〈0.01）. LVMI in HMS group was increased significantly, compared with other groups. SDNN-index were inversely related to HOMA-IR, and LVMI were positively related to HOMA-IR. Conclusion Depressed HRV could reflect the autonomic imbalance in MS patients and were inversely correlated with HOMA-IR. Metabolic factors which are the same to hemodynamic factors in patients can lead to left ventricular remolding.

关 键 词：代谢疾病 葡萄糖代谢障碍 高血压 肥胖症 血脂异常 心率 心室功能 左 

分 类 号：R589[医药卫生—内分泌]