高血压病心率变异性临床分析

Clinical analysis of heart rate variability in patients with hypertension

目的研究高血压患者不同危险分层以及心率变异性的改变与心脏自主神经功能损害程度的关系。方法应用24 h动态心电图对268例高血压患者(高血压组)与71例正常人(对照组)进行心率变异性检查,对高血压患者进行危险分层,根据危险分层和心、肾损害情况,对心变异性检查结果进行对比分析。结果实验组患者时域指标及频域指标中的高频成分较对照组降低,低频成分较对照组升高(P<0.05);实验组从低危、中危、高危到极高危险组时域指标及频域指标中高频成分逐渐降低,低频成分升高(P<0.05);高血压病伴左心室肥厚与不伴左心室肥厚患者相比,时域指标及频域指标中高频成分降低,低频成分升高(P<0.05);高血压病伴肾功能不全(代偿期)或氮质血症期患者与单纯高血压患者时域指标和频域指标无显著性差异。结论高血压患者存在自主神经功能受损,其损害程度随高血压危险度增加而逐渐加重。

Objective It is to study the relationship of different dangerous classes and changes of heart rate variability with injury degree of heart autonomic nerve＇s function. Methods 268 patients with hypertension （experimental group） and 71 healthy people （control group） were given examination of heart rate variability with 12h dynamic electrocardiogram and divided into different groups on the basis of dangerous classes. The result of examination of heart rate variability was compared and analyzed according to the classes and injury of heart and kidney. Results Compared with those in control group and in patients with hypertension not complicating with left ventricular hypertrophy, high frequency element in the indexes of time domain and frequency domain was lower and low frequency was higher both in experimental group and in patients with left ventricular hypertrophy （P〈 0.05）. The high frequency element gradually lowed down and low frequency element rose up from groups of slight dangerous, midrange dangerous and high dangerous to serious dangerous group （P〈 0.05）. There was no significant difference in time domain and frequency domain between patients with hypertension complicating with renal inadequacy or azotemia and ones with hypertension only. Conclusion Autonomic nerve＇s function in patients with hypertension was damaged, which gradually gets worse when the dangerous degree of hypertension increases.