原发性高血压患者餐后低血压与24 h平均心率、心率变异性及颈动脉斑块的相关性研究  

Relationship Among Postprandial Hypotension And 24-hour Average Heart Rate,Heart Rate Variability,Carotid Artery Plaque in Primary Hypertension Patients

作　　者：赵伟 侯晓 夏营营 王建秋 赵海英 ZHAO Wei;HOU Xiao;XIA Yingying;WANG Jianqiu;ZHAO Haiying(Department of Internal Medicine,the fourth People's Hospital of Liaocheng,Liaocheng 252000,China;Department of Geriatric Rehabilitation,the fourth People's Hospital of Liaocheng,Liaocheng 252000,China)

机构地区：[1]山东省聊城市第四人民医院内科病房,山东聊城252000 [2]山东省聊城市第四人民医院老年康复科,山东聊城252000

出　　处：《中国医药指南》2022年第29期88-90,共3页Guide of China Medicine

摘　　要：目的分析原发性高血压患者餐后低血压与24 h平均心率、心率变异性及颈动脉斑块的关系。方法选择121例原发性高血压患者,根据有无餐后低血压分为餐后低血压组(PPH组,n=70)和非餐后低血压组(非PPH组,n=51),测定两组血液生化指标、完善24 h动态心电图获得24 h平均心率、心率变异性指标(包括SDNN,SDNN Index,rMSSD,PNN50),经彩超测定颈动脉斑块,检测患者的颈动脉内膜中层厚度(ITM),计算斑块Crouse斑块积分,比较两组上述各指标差异。结果PPH组年龄及高血压病程明显大于非PPH组(P<0.01)。PPH组24 h平均心率较非PPH组明显增快(P<0.01),PPH组SDNN、SDNN Index、rMSSD明显低于非PPH组(P<0.01)。PPH组Crouse积分、斑块检出率明显高于非PPH组(P<0.05)。PPH组血浆同型半胱氨酸、胱抑素C较非PPH组明显升高(P<0.01)。Logistic回归分析表明,24 h平均心率、年龄、高血压病程、SDNN、SDNN Index、Crouse积分是影响餐后低血压的因素。结论24 h平均心率增快、年龄越大、高血压病程长、心率变异性降低、Crouse积分高均与餐后低血压有关。Objective To analysis the relationships of postprandial hypotension and 24-hour average heart rate,heart rate variability and carotid artery plaque in primary hypertension patients.Methods Choose 121 cases patients with essential hypertension.They were divided into postprandial hypotension group(PPH group,n=70)and non-postprandial hypotension(non-PPH group,n=51)according to the presence or absence of postprandial hypotension.Measure the 2 hour blood biochemical indexes of the two groups,improve 24 hour Holter ECG to obtain 24 hour average heart rate,heart rate variability indicators including SDNN,SDNN Index,rMSSD,PNN50.Crouse score of plaque detected by carotid ultrasonography.Compare the differences between the two groups of indicators.Results The age and course of hypertension of PPH group are obviously higher than that of non-PPH group(P<0.01).The 24 hour average heart rate of PPH group are obviously higher than that of non-PPH group(P<0.01).The SDNN,rMSSD and PNN50 of the PPH group were significantly lower than those of the non-PPH group(P<0.01).As compared to non-PPH group,the detection rate of plague and Crouse score of plaque in PPH group were significantly increased(P<0.05).Serum homocysteine and cystatin C in the PPH group are significantly higher than that in the non-PPH group(P<0.01).Logistic regression analysis showed that 24 hour average heart rate,age,duration of hypertension,SDNN,SDNN Index,Crouse score of plaqueare the factors that affects postprandial hypotension.Conclusion The faster the 24 hour average heart rate and the older the age,long duration of hypertension,decreased heart rate variability,higher crouse score of plaque all related to postprandial hypotension.

关 键 词：24 h平均心率 餐后低血压 心率变异性 Crouse积分 

分 类 号：R544.1[医药卫生—心血管疾病]