单纯收缩期高血压患者心率震荡临床分析

The heart rate turbulence in patients with isolated systolic hypertension

目的观察单纯收缩期高血压（ISH）患者心率震荡的变化。方法ISH患者85例，普通高血压患者80例，健康对照组58例，记录其24h动态心电图，计算窦性心率震荡初始值（TO）与震荡斜率值（TS），比较3组之间的差异。结果3组间心率震荡差异有统计学意义（P〈0．01），ISH组和普通高血压组TO和TS较对照组明显降低（均P〈0．05）。ISH组TS较普通高血压组明显降低（P〈0．05），而TO差异无统计学意义。结论原发性高血压患者心率震荡明显减弱，且ISH患者较普通高血压患者更加明显。提示心脏自主神经功能紊乱可能对高血压的发生及预后有重要影响。

Objective To observe the changes of the heart rate turbulence （HRT） in patients with isolated systolic hypertension（ ISH）. Methods 85 patients with ISH,80 patients with common hypertension and 58 control subjects were investigated. Turbulence onset（TO） and turbulence slope （TS） were recorded of 24 hours dynamic electrocardiogram. Results The difference of HRT in the three groups was significant （ P 〈 0, 01 ）. The values of TO and TS was significantly higher in common hypertension group and ISH group than in control group （ P 〈 0.05 ） ; TS was significantly lower in ISH group than in common hypertension group （ P 〈 0.05 ） , but the difference of TO between ISH group with common hypertension group was not obvious. Conclusion The HRT in patients with primary hypertension is significantly lower,whlch is more significant in patients with ISH than in patients with common hypertension. It suggests that the cardiac autonomic nerves dysfunction perhaps has an important influence on development of hypertension and its prognosis.