动态心率变化对高血压患者预后的影响  

The effect of dynamic change of heart rate on the prognosis of patients with hypertension

作　　者：白梅[1] 李学文[2] 彭瑞华[1] 

机构地区：[1]太原市人民医院,030001 [2]山西医学科学院山西大医院,030032

出　　处：《临床心电学杂志》2013年第6期432-435,共4页Journal of Clinical Electrocardiology

摘　　要：目的探讨高血压患者杓型心率，非杓型心率，静息心率，平均心率，夜间心率，日间心率的动态变化与自主神经功能的关系及对预后的影响。方法随机选取原发性高血压患者145例，对其中102例患者进行0．5。5年随访。分为杓型心率组和非杓型心率组。所有患者均接受24h动态心电和动态血压同步监测，采集静息心率（RHR），平均心率（RHR），夜间心率（NHR），昼间心率（DHR），心率变异的低频（LF），高频（HF）值进行分析。结果杓型HR组心率变异昼夜比较：夜间LF，HF明显高于昼间（p〈0．05），但LF／HF比值昼〉夜。非杓型HR组与杓型HR组比较：昼间LF减低，夜间LF，HF均显著减低（p〈0．05），RHR，AHR，NHR均显著增高（P〈0．001，p〈0．05）。事件组与非杓型心率组比较：昼间HF显著减低（p〈0．05），DHR显著增高（p〈0．05）。事件组与非事件组比较：昼夜LF，HF均显著减低（p〈0．001，p〈0．005），RHR，AHR，NHR，DHR均显著增高（p〈0．005）。死亡组与事件组比：昼夜LF，夜间HF均显著减低（p〈0．05，p〈0．01），RHR，NHR均显著增高（p〈0．05）。结论高血压患者随着病情的加重自主神经功能呈进行性减低，心率则进行性加快。Objective To explore the variation of dipper heart rate, non-dipper heart rate, resting heart rate （RHR）, average heart rate （AHR）, day heart rate （DHR）, night heart rate （NHR） in hypertension patients, and analyze the relationship between dynamic changes of heart rate and the autonomic nervous function, provide the predictor for prognosis. Methods 145 cases of patients with essential hypertension were randomly selected, and followed up for 0.5-5 years, patients were divided into the dipper heart rate group （〉10%） and the non-dipper heart rate group （〈10%）. All patients were synchronously monitored by 24h Holter and ambulatory blood pressure. Observe resting heart rate （RHR）, average heart rate （AHR）, day heart rate （DHR）, night heart rate （NHR）, LF, HF（the quantitative index of heart rate variability）. Results Comparing night with clay in the group of the dipper heart rate ： the mean of LF, HF were significantly higher （p〈0.05）,but the value of LF/HF at day was higher than that at night. Comparing Non-dipper heart rate group with dipper heart rate group：The value of LF decreased at day, and the value of LF, HF were significantly lower at night （p〈0.05）; RHR, AHR, NHR were significantly higher （p〈0.001, p〈0.05）. Comparing the event group with the non-clipper group： HF was significantly lower （,0〈0.05） at day, DHR was significantly higher （p〈0.05）. Comparing the event group with the non-event group： LF, HF at day and night were significantly lower （p〈0.001, p〈0.005）, RHR, AHR, NHR, DHR were significantly higher （p〈0.005）. Comparing the death group with the event group： LF at day and night,HF at night were significantly lower （p〈0.05, p〈0.01）, RHR, NHR were significantly higher （p〈0.05）. Conclusions Hypertensive patients showed a progressive reduction with the aggravation autonomic function. Heart rate of hypertensive patients early due to the dysregulation of the autonomic nervous system function,

关 键 词：高血压 自主神经功能 动态心率 预后 

分 类 号：R544.1[医药卫生—心血管疾病]