PM_(2.5)对急性冠脉综合征患者心率变异性、心率和血压的影响  

Effect of PM_(2.5) on heart rate variability,heart rate and blood pressure of acute coronary syndrome patients

作　　者：王丽华[1] 郭伟丽 赵利培 李石林[1] 李医博 吴卫东[2] 刘玲玲[1] 

机构地区：[1]新乡市中心医院心内科,河南新乡453000 [2]新乡医学院公共卫生学院,河南新乡453000

出　　处：《河南医学研究》2017年第20期3659-3662,共4页Henan Medical Research

基　　金：新乡市科技攻关项目(ZG15032)

摘　　要：目的探讨PM_(2.5)对急性冠脉综合征(ACS)患者心率变异性(HRV)、心率和血压的影响。方法监测2015年11月至2016年4月空气质量状况,选择PM_(2.5)中度污染及其以上期间,在新乡市中心医院心内科入院的ACS患者(ACS组)138例和非冠心病组(NCHD组)142例,ACS组于发病72 h内对患者进行24 h动态心电图检查、血压测量,同时NCHD组患者也进行24 h动态心电图检查和血压测量,记录所有入选患者的心率变异性指标数值、平均心率和血压。结果 (1)ACS组时域指标正常窦性RR间期标准差(SDNN)、正常连续窦性RR间期差值均方根(RMSSD)均小于NCHD组(P均<0.05);频域指标超低频功率(VLF)、低频功率(LF)、高频功率(HF)、低频功率/高频功率(LF/HF)均小于NCHD组(P均<0.05)。(2)ACS组平均心率和收缩压高于NCHD组(P均<0.05),两组舒张压差异无统计学意义(P>0.05)。结论 PM_(2.5)暴露可以使ACS患者HRV降低,24 h平均心率增高,收缩压升高,使NCHD患者收缩压也升高,但是没有ACS组患者收缩压升高明显。Objective To study the effect of fine particulate matter (particulate matter 2.5,PM_(2.5)) on heart rate variability (HRV),heart rate and blood pressure in acute coronary syndrome (ACS) patients.Methods The air quality condition from November of 2015 to April of 2016 was monitored,138 ACS patients and 142 non coronary heart disease (NCHD) patients were recruited who hospitalized in Xinxiang Central Hospital when the air quality were medium pollution and over medium pollution.Twenty-four hours ambulatory electrocardiogram examination and blood pressure measurement were performed in ACS patients within 72 hours after onset,the NCHD patients were carried above noted examination at the same time.The HRV indices value,average heart rate and blood pressure results of all the recruited subjects were documented.Results(1) The time domain indices which included standard deviation of normal to normal intervals (SDNN) and the square root of the mean squared differences of successive normal heart beats (RMSSD) were significantly lower in the ACS group than that in the NCHD group (P all < 0.05),and the frequency domain indices which included very low frequency (VLF),low frequency power (LF),high frequency power (HF) and LF/HF were significantly lower in the ACS group than in the NCHD group (P all < 0.05).(2) The average heart rate and systolic pressure in the ACS group were significantly higher than in the NCHD group (P all < 0.05),while the diastolic pressure was similar between the two groups (P > 0.05).Conclusion PM_(2.5) exposure can reduce the HRV,increase the average heart rate and systolic pressure in the ACS patients,and increase the systolic pressure in the NCHD patients,while the higher systolic pressure in the ACS patients is more obvious.

关 键 词：PM2.5 急性冠脉综合征 心率变异性 血压 

分 类 号：R541.1[医药卫生—心血管疾病]