高血压患者频发室性早搏与心率变异的关系

Relation Between Frequent Ventricular Premature Complexes and Heart Rate Variability in Patients with Essential Hypertension

目的分析伴有频发室性早搏（室早）的高血压患者的心率变异及二者的关系。方法对２４ｈ动态心电图检查中室早＞１０次／ｈ的２６例高血压患者和２６例无器质性心脏病患者（室早对照组）的心率变异时域指标进行分析，并与２６例无室早的正常人和２７例无室早的高血压患者对照。用直线相关分析确定室早与心率变异指标之间的关系。结果室早对照组平均Ｒ－Ｒ间期显著小于高血压组，其余各心率变异指标无明显差异；这两组的窦性Ｒ－Ｒ间期标准差和全部５ｍｉｎ节段Ｒ－Ｒ间期均值的标准差均显著低于正常对照组。有室早的高血压组与无室早的高血压组之间的心率变异无显著差异。相关分析显示室早对照组的室早对数与平均Ｒ－Ｒ间期呈显著负相关，其余心率变异指标与室早之间无显著相关性。结论高血压患者心率变异下降，但其室早与心率变异之间未发现明显关系。

Aim\ To analyse heart rate variability(HRV) and its relationship to frequent ventricular premature complexes(VPC) in hypertensive patients.\ Methods\ Time domain indices of HRV were analysed from 24 hour electrocardiographic recordings in 105 subjects.\ Among them,26 patients with essential hypertension and 26 normal subjects with VPC>10/h (Group Ⅰand Group Ⅱ),26 normal subjects and 27 essential hypertensive patients without VPC(Group Ⅲ and Group Ⅳ).\ Results\ Mean RR intervals was significantly lower in Group Ⅱ than in Group Ⅰ,but no significant differences were found in other HRV indices between them.\ Standard deviation of all normal RR intervals(SD) and standard deviation of the average normal RR intervals for 5 min segments(SDA) in group were significantly lower than those in Group Ⅲ, but no significant differences in all HRV indices were found between Group Ⅰand Group Ⅳ.\ An significant inverse linear correlation was found between logarithm of VPC and mean RR intervals in Group Ⅱ. No significant correlations were observed between VPC and other HRV indices in both of Group Ⅰand Ⅱ.\ Conclusion\ Heart rate variability decreased in patients with essential hypertension but no association was found between VPC and HRV.