原发性高血压患者伴心肌缺血时心率变异性与室性心律失常之间的关系  

The relationship between heart rate variability and ventricular arrhythmia in the essential hypertension patients with myocardial ischemia

作　　者：罗昭林[1] 钟杭美[1] 祝善俊[1] 李刚[2] 张晓燕[1] 文芳[1] 

机构地区：[1]第三军医大学新桥医院心内科全军心血管内科中心,重庆市400037 [2]中国人民解放军第6905厂医院,重庆市400712

出　　处：《临床心电学杂志》2003年第2期90-92,共3页Journal of Clinical Electrocardiology

摘　　要：目的　探讨原发性高血压 (EH)患者伴心肌缺血 (MI)时心率变异性 (HRV)与室性心律失常之间的关系。方法　对 90例EH患者 ,根据动态心电图上有无MI ,分为MI组 (40例 )和无MI组 (5 0例 ) ,并与 2 0例健康体检者 (对照组 ,2 0例 )进行对照 ,观察HRV的时域指标和室性心律失常。结果　EH患者中HRV时域指标SDNN、SDANN、SDNNindex、rMSSD和PNN5 0 ,除夜间SDNNindex外 ,其余时间各项指标均明显低于对照组 (P <0 .0 5～ 0 .0 1) ,在EH患者中MI组白天和夜间SDNNindex、白天rMSSD与无MI组无差异 ,其余指标MI组明显低于无MI组 (P <0 .0 5～ 0 .0 1) ;EH患者中 2 4h室早总数明显于对照组 (P<0 .0 5～ 0 0 1) ,而EH患者中MI组室早总发生率和LownⅢ级以上室早总发生率明显高于MI组和对照组 (P <0 .0 5～ 0 .0 1)。结论　EH患者中HRV减低 ,反映了高血压患者心脏自主神经调节功能失衡 ,尤其在伴有MI的患者中更为明显 ,这类患者更易出现复杂室性心律失常。Objective To observe the relationship between heart rate variability(HRV)and ventricular arrhythmia(VA)in the essential hypertension(EH)patients with myocardial ischemia(MI).Methods Ninety EH patients were divided into MI group(40 cases) and no MI group(NMI,50 cases) based on with and without MI in ambulatory electrocardiogram,and 20 healthy subjects(control group)were compared.To analyse the HRV and VA differences between three group.Results SDNN?SDANN?SDNNindex?rMSSD and PNN50 of HRV in the EH patientswere lower than control group,except SDNNindex in the night(P<0.05～0.01 ).SDNNindex in the day and night,rMSSD in the day were no significant difference,other parameter were significally difference between in the MI group alld NMI group inthe EH patients(P<0.05～0.01).The total number of ventricular premature complexes(VPC) was more in the EH patients than in the control group (P<0.05～0.01 ).The incidence and Ⅲ grade and higher of the VPC in the MI group were higher than in the NMI and control group (P<0.05～O.01).Conelusion In the EH patients, imbalance of the autonomic nervous system lead to HRV decrease,especially in the EH patients with MI.These patients induce easily severe VA.

关 键 词：原发性高血压 心肌缺血 心率变异性 室性心律失常 并发症 关系 

分 类 号：R544.1[医药卫生—心血管疾病] R542.2[医药卫生—内科学]