原发性高血压患者静息心率与血脂及靶器官损害的相关性研究

Relationship of the resting heart rate with blood lipid and target organ damage in patients with hypertension

目的研究高血压患者静息心率（RHR）与血脂及靶器官损害的关系。方法157名高血压患者按RHR分为3组，其中RHR〈70次／min为A组（52例），RHR在70～80次/min为B组（56例），RHR〉80次／min为C组（49例）。检测三组患者血清总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL—C）及低密度脂蛋白胆固醇。超声心动图检测左室后壁及室间隔厚度（LVPWT、IVST）。计算左室质量指数（LVMI），测量二尖瓣血流E峰最大流速值（E）及A峰最大流速值（A），计算E／A比值。超声心动图检测颈动脉内膜中层厚度（CIMT）。结果三组血脂比较差异有显著性（P〈0．05）；随静息心率增加，血TC、TG及LDL-C水平升高，血HDL-C水平降低。三组患者LVPWT、IVST、LVMI、E／A比值及CIMT差异有显著性（P〈0．05）；随着静息心率增加，LVPWT、IVST、LVMI、CIMT增加，E／A比值降低。RHR与TC、LDL—C、TG、LVMI及CIMT呈正相关（P〈0．05），与HDL—C和E／A呈负相关（P〈0．05）。结论高血压患者静息心率与血脂代谢异常及靶器官损害密切相关。

Objective To study the correlation of the resting heart rate with blood lipid and the target organs damage in patients with hypertension. Methods 157 patients with hypertension were divided into three groups： group A （RHR 〈 70 bpm, n = 52 ） ;group B （RHR≥70 bpm, 〈 80 bpm, n =56） ; and group C（RHR≥80 bpm, n =49）. Serum TC, TG, HDL-C, LDL-C and LVPWT, IVST, LVMI, E/A, CIMT were determined in all patients. Results The serum TC, TG, HDL-C, LDL-C and LVPWT, IVST, LVMI, E/A, and CIMT were significant different in three groups. The serum TC,TG LDL-C and LVPWT, IVST, LVMI, CIMT were positively correlated with RHR（ P 〈 0.05 ）, and negatively correlated with HDL-C and the ratio of E/A （P 〈 0.05 ）in hypertensive patients. Conclusion Resting heart rate was associated with the blood lipid and the target organ damage （TOD）.