老年原发性高血压患者餐后血糖与心率震荡、左心室结构和功能的关系  

Association of postprandial blood glucose with heart rate turbulence,left cardiac structure and function in elderly patients with primary hypertension

作　　者：郭芳[1] 刘振东[2] 路方红[2] 曹春林[1] 

机构地区：[1]山东大学附属省立医院,济南250021 [2]山东省医学科学院基础医学研究所心血管病防治研究中心

出　　处：《山东医药》2013年第36期24-27,共4页Shandong Medical Journal

摘　　要：目的分析老年原发性高血压患者餐后血糖与心率震荡、左心室结构和功能的关系。方法将257例老年高血压患者,根据口服葡萄糖耐量试验结果分为餐后血糖正常组(115例)、糖耐量减退组(79例)和糖尿病组(63例)。均行24 h动态心电图检查,计算震荡初始和震荡斜率,记录24 h室性期前收缩数目、24 h连续正常RR间期的标准差(SDNN);超声心动图观察左心室结构及功能。结果与正常组比较,糖耐量减退组、糖尿病组震荡初始、24 h室性期前收缩总数、左心室收缩末期内径(LVESD)、室间隔厚度(IVST)、Tei指数明显升高(P均<0.01),震荡斜率、24 h连续正常RR间期的标准差(SDNN)、左心室短轴缩短率(LVFS)、左心室射血分数(LVEF)、E/A值明显降低(P均<0.01)。多元线性回归分析显示,血糖与震荡初始、震荡斜率、IVST、Tei指数、LVFS、LVEF、E峰、E/A相关。结论老年原发性高血压患者餐后血糖水平与心室结构、功能及心率震荡有关。Objective To explore the association of postprandial blood glucose with heart rate turbulence, cardiac structure and cardiac function in elderly patients with primary hypertension. Methods Oral glucose tolerance tests were performed in 257 elderly patients with primary hypertension. According to the results, they were divided into the control group （n = 115）, high postprandial blood glucose group （n = 79） and diabetes group （n = 63 ）. All participants underwent 24 h ambulatory electrocardiogram, the turbulence onset and turbulence slope were calculated, the number of 24 h premature ventricular contraction, 24 h continuous standard deviation of normal RR intervals （SDNN） were recorded; and the structure and function of left ventricular were observed. Results Compared with the control group, the turbulence onset, 24 h total premature ventricular contraction, the left ventricular end-systolic diameter （LVESD）, interventricular septum thickness （IVST） and Tei index in the high postprandial blood glucose group and diabetes group were significantly increased （ all P 〈 0.01 ）, while their turbulence slope, 24 h continuous standard deviation of normal RR interval （ SDNN）, left ventricular fractional shortening （LVFS）, left ventricular ejection fraction （LVEF）, and E/A ratio were all significantly decreased （all P 〈0.01 ）. Multivariate linear regression analysis showed that postprandial blood glucose level was related to turbulence onset, turbulence slope, IVST, Tei index, LVFS, LVEF, E peak and E/A ratio. Conclusion Postprandial blood glucose of elderly patients with primary hypertension is correlated with the changes in cardiac structure, cardiac function, and heart rate turbulence.

关 键 词：原发性高血压 餐后血糖 心率震荡 心脏结构 心脏功能 

分 类 号：R544.1[医药卫生—心血管疾病]