OSAHS合并高血压患者窦性心率震荡的研究  

Analysis of the sinus heart rate turbulence and chronotropic response in patients with obstructive sleep apnea-hypopnea syndrome complicated with hypertension

作　　者：欧阳清彦[1] 涂爱兰[1] 邹月娥[1] 赵惠莉[1] 梁健球[1] 胡辉星[1] 

机构地区：[1]广东省佛山市第二人民医院,528000

出　　处：《临床心电学杂志》2012年第6期425-427,430,共4页Journal of Clinical Electrocardiology

基　　金：广东省佛山市医学类科技攻关项目(编号:201108025)

摘　　要：目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)合并高血压患者窦性心率震荡(HRT)、心脏变时性功能的变化。方法 OSAHS合并高血压组(OH组)68例、高血压组(H组)34例和健康对照组(N组)21例,所有对象行多导睡眠图监测(PSG)、24h动态心电图监测及平板运动试验,分别计算各组HRT的两个参数:震荡初始(TO)与震荡斜率(TS)、心脏变时性功能的两个指标:运动中实测最大心率(HRmax)与年龄预测最大心率(APMHR)之比(rHR)、运动后1min心率恢复值(HRR-1)。结果 OH组TO明显高于H组及N组,TS明显低于H组及N组,差异具有显著性(p<0.05);OH组rHR、HRR-1明显低于H组及N组,差异具有显著性(p<0.05)。TO、TS、rHR、HRR-1在OH组阳性率明显高于H组及N组,组间比较差异有统计学意义(p<0.05)。结论 OSAHS合并高血压患者较单纯高血压患者HRT减弱、心脏变时性功能降低,OSAHS使高血压患者自主神经功能受损加重。Objective To explore the heart rate turbulence and chronotropic response in patients with obstructive sleep apnea-hypopnea syndrome（OSAHS） complicated with hypertension. Methods Sixty eight patients with OSAHS complicated with hypertension（Group OH）, 34 patients with hypertension（Group H） and 21 contorl subjects（Group N） were enrolled, all subjects underwent PSG and 24- hours dynamic electrocardiogram and treadmill exercise test, heart rate turbulence was measured and expressed as turbulence onset （TO） and turbulence slope（TS）, chronotropic response was measured and expressed as the percent age-predicted maximal heart rate achieved（rHR） and HRR-1. Results In patients with OSAHS complicated with hypertension TO was higher than those in the other two groups, TS, rHR and HRR-1 were lower than those in the other two groups, the group comparison had significant difference. The positive detection rate of TO, TS, rHR and HRR-1 of patients with OSAHS complicated with hypertension were higher than the other two groups, the group comparison had significant difference. Conclusion In patients with OSAHS complicated with hypertension, HRT and chronotropic response were lower than those in the patients with hypertension, the function of autonomic nerve and balance between sympathetic nerve and vagus nerve in the patients with OSAHS complicated with hypertension were more deteriorated than patients with hypertension.

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 高血压 窦性心率震荡 心脏变时功能 

分 类 号：R544.1[医药卫生—心血管疾病] R766[医药卫生—内科学]