高血压病患者心率变异性和心率震荡与血压控制之间的关系  

Clinical study of the relationship between heart rate variability,heart rate turbulence and blood pressure control in hypertensive patients

作　　者：余意君[1] 邹武松[2] 朱朋飞[2] 张明静 徐艳玲[1] 吴慧君[1] 郑伟[1] 谢亚文 顾晔[2] 

机构地区：[1]武汉市普爱医院心电生理科,武汉430033 [2]武汉市普爱医院心内科,武汉430033

出　　处：《实用医学杂志》2018年第1期71-75,共5页The Journal of Practical Medicine

摘　　要：目的探讨高血压病患者心率变异性(HRV)和心率震荡(HRT)与血压控制之间的关系。方法分析2015年6月至2016年6月住院的高血压病血压未控制组40例、高血压病血压控制组50例、对照组非高血压病52例的一般临床特征、HRV和HRT指标。结果 (1)高血压病血压控制组体质指数高于对照组;高血压病血压未控制组和血压控制组所用降压药比例和用药种类数量差异无统计学意义(P>0.05)。(2)高血压病血压未控制组极低频(VLF)、低频(LF)和震荡斜率(TS)低于对照组,高血压病血压未控制组高频(HF)显著低于血压控制组(P<0.05)。(3)多因素Logistic回归分析显示,在校正性别、年龄、EF值、肌酐、血脂、β受体阻滞剂和合并吸烟史、冠心病史、糖尿病史影响后,r MSSD、p NN50、VLF、LF、HF、TS降低是高血压病血压控制的危险因素。(4)对高血压病患者HRV和HRT作Spearman相关分析显示,LF与TO呈负相关;SDNN、SDANN、r MSSD、p NN50、VLF、LF、HF与TS呈正相关。结论血压未控制的高血压病患者HRV和HRT异常,存在自主神经功能受损。Objective To explore the relationship between heart rate variability （HRV）, heart rate turbu- lence （HRT） and blood pressure （BP） control in hypertensive patients. Methods Hypertensive patients with con- trolled BP group （n = 50） and uncontrolled BP group （n = 40） and control group non-hypertensive patients （n = 52） were enrolled in this study in our hospital during June 2015 to June 2016. HRV and HRT as well as clinical charac- teristic of the three groups were analyzed. Results （ 1 ） Body mass index was significantly higher in the controlled BP group than in the control group. There was no statistical difference in proportions and categories of antihyperten- sive medication between the uncontrolled and controlled BP groups （P 〉 0.05）. （2） VLF, LF and TS were signifi- cantly lower in the uncontrolled BP group than the control group, and HF was significantly lower in the uncontrolled BP group than in the controlled BP group （P 〈 0.05）. （3） Results of multiple logistic regression analysis showed that lower rMSSD, pNN50, VLF, LF, HF and TS were risk factors for BP control after adjusting for gender, age, EF val- ue, creatinine, blood lipids, Beta-blockers and history of smoking, coronary heart disease and diabetes mellitus. （4） Spearman correlation analysis of the hypertensive patients showed that LF was negatively correlated with TO, and SDNN, SDANN, rMSSD, pNN50, VLF, LF, HF were positively correlated with TS. Conclusion The present results demonstrate that uncontrolled BP is associated with abnormal HRV and HRT, which suggested autonomous nervous imbalance was existed in uncontrolled hypertensive patients.

关 键 词：高血压病 心率变异性 心率震荡 自主神经功能 

分 类 号：R544.1[医药卫生—心血管疾病]