单纯收缩期高血压患者的心率震荡与心率变异

Study of heart rate turbulence and heart rate variability in patients with isolated systolic hypertension

目的:观察单纯收缩期高血压(ISH)患者的心率震荡(HRT)和心率变异(HRV)的变化。方法:记录24h动态心电图,计算窦性HRT的初始值(TO)和震荡斜率值(TS)以及HRV的SDNN、pNN50和LF/HF,比较ISH组(85例)、普通高血压组(80例),正常对照组(58例)3组之间的差别,分析HRT和HRV之间的相关性。结果:ISH组、普通高血压组的HRT和HRV与正常对照组的HRT和HRV比较差异均有统计学意义(P<0.05),ISH组的TS和LF/HF较普通高血压组明显降低(P<0.05);HRV的各项指标和HRT均有良好的相关性,其中pNN50与HRT相关系数最高。结论:原发性高血压患者有显著的HRT减弱及HRV的异常,其中ISH患者较普通高血压患者更加明显,且HRT与HRV的密切相关,表明心脏自主神经功能紊乱可能对于高血压的发生及预后均有重要影响。

Objective：To observe the change of the heart rate turbulence （HRT） and heart rate variability （HRV） in patients with isolated systolic hypertension （ISH）. Method：Eighty-five patients with isolated systolic hypertension（ISH）, 80 patients with common hypertension and 58 control subjects were investigated. Turbulence onset （TO）, turbulence slope （TS）,SDNN,pNN50 and LF/HF were measured by using recorded 24 hours dynamic electrocardiogram. The difference of the groups were compared, and the correlation between the groups were analyzed. Result： HRT and HRV were significantly different between hypertension groups （ISH and common hypertension） and control group （P〈0. 05）. TS and LF/HF were significantly lower in ISH group than in common hypertension group （P〈0.05）. Good correlations were found between the HRT parameters and HRV parameters. The correlation coefficient between pNN50 and TO/TS were most highest. Conclusion： HRT and HRV in patients with primary hypertension are significantly abnormal and they are more significant in patients with ISH than in patients with common hypertension. And there is a strong correlation between HRT and HRV. It suggested that the cardiac autonomic nerves dysfunction perhaps has an important influence on hypertension generation and prognosis.