原发性高血压病人心率变异性与动脉硬化的相关性  

Correlation between heart rate variability and arteriosclerosis in patients with essential hypertension

作　　者：李健武[1] 林松青[1] 黎明[1] 何超凡 黄威[1] 黄宇明[1] 

机构地区：[1]广东省佛山市南海区第六人民医院内科,广东佛山市528248

出　　处：《心血管康复医学杂志》2017年第2期149-154,共6页Chinese Journal of Cardiovascular Rehabilitation Medicine

基　　金：佛山市医学类科技攻关项目(2014AB000222)~~

摘　　要：目的:研究原发性高血压病人心率变异性(HRV)和动脉硬化的相关性。方法:选择我院原发性高血压患者139例(高血压组),按颈-股脉搏波速度(PWV)≥9m/s和<9m/s分为异常亚组(74例)和正常亚组(65例),另选择同期来院体检的健康成人60例(健康对照组),比较各组HRV指标、PWV值、颈动脉内膜中层厚度(IMT)及颈动脉斑块数,分析高血压患者上述指标间的相关性。结果:与健康对照组比较,高血压组24h每5min正常RR间期均值的标准差[SDANN,(142.3±21.4)ms比(119.3±16.5)ms]明显减小,低频[LF,(341.7±37.9)Hz比(695.4±43.3)Hz]、高频[HF,(519.1±33.6)Hz比(636.8±39.5)Hz]、LF/HF[(0.6±0.3)比(1.0±0.2)]、PWV[(7.44±0.82)m/s比(11.13±0.65)m/s]及IMT[(1.03±0.24)mm比(1.74±0.41)mm]值明显增加(P均<0.01);高血压组中,与PWV正常亚组比较,PWV异常亚组SDANN明显减小,LF、HF、LF/HF、IMT值及人均颈动脉斑块个数明显增多(P<0.05或<0.01);Pearson相关性分析显示高血压患者中PWV及IMT水平均与SDANN显著负相关(r=-0.713、-0.699,P均<0.01),与LF、HF、LF/HF及颈动脉发现斑块数呈显著正相关(r=0.506~0.935,P均<0.01),且PWV与IMT之间也显著正相关(r=0.883,P=0.001)。结论:原发性高血压患者HRV中SDANN、LF、HF、LF/HF指标与动脉硬化程度有显著相关性,在治疗中除降血压外,还应处理与动脉病理性改变有关的HRV等因素。Objective： To study correlation between heart rate variability （HRV） and arteriosclerosis in patients with essential hypertension （EH）. Methods： A total of 139 EH patients from our hospital were enrolled as EH group. According to carotid-femoral pulse wave velocity （PWV）, they were divided into normal subgroup （n = 65, PWV〈9 m/s） and abnormal subgroup （n = 74, PWV≥9 m/s）. Another 60 healthy adults undergoing physical examination in our hospital during the same period were selected as healthy control group. HRV indexes, PWV, carotid intima- media thickness （IMT） and number of carotid plaques were compared among all groups, Correlation among above indexes were analyzed in EH patients. Results： Compared with healthy control group, there was significant reduction in standard deviation of normal to normal RR intervals in all 5 min segments of the entire recording [SDANN, （142.3 ± 21.4） ms vs. （119.3 ± 16.5） ms], significant rise in low frequency [LF, （341.7 ± 37.9） Hz vs. （695.4 ±43.3） Hz], high frequency EHF, （519.1±33.6） Hzvs. （636.8±39.5） Hz], LF/HF [ （0.6±0.3） vs. （1.0± 0.2）], PWV [ （7.44±0.82） m/svs. （11.13±0.65） m/s] and IMT[ （1.03±0.24） mmvs. （1.74±0.41） mm] in EH group, P〈0. 01 all; in EH group, compared with normal PWV subgroup, there was significant reduction in SDANN, and significant rise in LF, HF, LF/HF, IMT and mean number of carotid plaques in abnormal PWV sub- group, P〈0.05 or 〈0.01; Pearson correlation analysis indicated that in EH patients, PWV and IMT were significant inversely correlated with SDANN （ r = - 0. 713, - 0. 699, P 〈0.01 both）, significant positively correlated with LF, HF, LF/HF and carotid plaques （r = 0. 506-0. 935, P〈0.01 all）, and PWV was significant positively correlated with IMT （r=0. 883, P=0. 001）. Conclusion： In EH patients, SDANN, LF, HF, LF/HF of HRV are significantly correlated with arteriosclerotic extent. Besides lowering blood pressure , HRV etc. related w

关 键 词：高血压 动脉硬化 自主神经系统 

分 类 号：R544.109[医药卫生—心血管疾病]