Holter联合ABPM监测对原发性高血压及合并稳定型冠心病病人自主神经功能评价  

VALUE OF HOLTER MONITORING COMBINED WITH AMBULATORY BLOOD PRESSURE MONITORING IN EVALUATING AUTONOMIC NERVE FUNCTION IN PATIENTS WITH ESSENTIAL HYPERTENSION AND STABLE CORONARY HEART DISEASE

作　　者：时瑀 韩冰 袁晓静[2] 李先池[2] 蔡艳[2] SHI Yu;HAN Bing;YUAN Xiaojing;LI Xianchi;CAI Yan(Xuzhou Affiliated Clinical College of Xuzhou Medical University,Xuzhou 221009,China)

机构地区：[1]徐州医科大学徐州临床学院,江苏徐州221009 [2]徐州市中心医院 [3]徐州市心血管病研究所

出　　处：《青岛大学学报（医学版）》2020年第6期700-703,共4页Journal of Qingdao University(Medical Sciences)

基　　金：江苏省科技厅重点研发项目(BE2015624)。

摘　　要：目的探讨24 h动态心电图(Holter)联合动态血压监测仪(ABPM)监测对原发性高血压及合并稳定型冠心病病人自主神经功能的评价。方法2018年7月—2020年1月,选择在我院诊断为原发性高血压病人80例,依据是否伴有稳定型冠心病分为两组,单纯高血压组(A组)41例及高血压合并稳定型冠心病组(B组)39例。所有病人应用Holter与ABPM监测心率变异性(HRV)、心率减速力(DC)及血压变异性(BPV)等指标。结果 B组正常R-R间期的标准差(SDNN)和DC较A组明显减低,白天、夜间平均舒张压及非杓型血压占比较A组明显增高(t=-3.705~7.573,χ2=8.451,P<0.05)。结论 合并稳定型冠心病的原发性高血压病人自主神经功能受损情况更加严重,联合Holter和ABPM同步监测可以单独评估迷走神经及交感神经的功能。ObjectiveTo investigate the value of 24 hour ambulatory electrocardiography(Holter monitoring)combined with ambulatory blood pressure monitoring(ABPM)in evaluating autonomic nerve function in patients with essential hypertension(EH)with or without stable coronary heart disease(CHD).MethodsA total of 80 patients who were diagnosed with EH in our hospital from July 2018 to January 2020 were enrolled,and according to the presence or absence of stable CHD,they were divided into hypertension group(group A with 41 patients)and hypertension+stable CHD group(group B with 39 patients).Holter monitoring and ABPM were performed for all patients to monitor the indices including heart rate variability(HRV),deceleration capacity of heart rate(DC),and blood pressure variability(BPV).ResultsCompared with group B,group A had significant reductions in standard deviation of all normal R-R intervals and DC and significant increases in mean daytime/nighttime diastolic pressure and proportion of patients with non-dipper blood pressure pattern(t=-3.705 to 7.573,χ2=8.451,P<0.05).ConclusionPatients with EH and stable CHD tend to have severe damage of autonomic nerve,and Holter monitoring combined with ABPM can evaluate the function of vagus nerve and sympathetic nerve separately.

关 键 词：原发性高血压 冠心病 自主神经系统疾病 心电描记术 便携式 血压监测 便携式 

分 类 号：R541.4[医药卫生—心血管疾病] R747[医药卫生—内科学]