高血压合并冠心病患者的心率变异性分析

Analysis of heart rate variability in the patients with essential hypertension and coronary heart disease

目的探讨高血压并发冠心病患者的心率变异性和心律失常的特点。方法对50例原发性高血压（EH）患者、44例冠心病（CHD）患者和52例EH并发CHD患者与35例健康老年人的心率变异性（HRV）进行对EE研究。结果EH组和CHD组与对照组HRV时域法所有参数差异均有统计学意义（P〈0.05）；EH并发cHD组与对照组比较，各参数差异均有统计学意义（P〈0.01）；但不同疾病组间比较，差异均无统计学意义（P〉0.05）。三个疾病组与对照组比较，房性期前收缩、房性心动过速和室性期前收缩的发生率差异均有统计学意义（P〈0.01）；而EH组、CHD组及EH＋CHD组间，除外CHD组与EH＋CHD组房性期前收缩的发生率差异有统计学意义（P〈0.05）外，其余差异均无统计学意义。结论高血压患者和冠心病患者的自主神经功能受损，心律失常发生率增加（以房性期前收缩最常见，其次为室性期前收缩）；当高血压患者并发冠心病时这种受损更加明显，其迷走神经张力降低，交感神经紧张性相对增高是导致老年患者心率变异性降低的主要原因和心律失常的可能因素。

Objective To study autonomic nerve regulator character and arrhythmias in the patients with essential hypertension（EH） and coronary heart disease（CHD）. Methods The heart rate variability（HRV） and arrhythmias in 50 EH, 44 CHD, 52 EH ＋ CHD patients and 35 health elderly subjects were investigated. Results There were significant differences of HRV in the patients with EH, CHD and healthy elderly subjects（ P 〈 0.05）. There was much significant difference of HRV between the patients with EH ＋ CHD and healthy elderly subjects（P 〈 0.01 ）, but no significant difference of HRV between the patients with EH and CHD（P 〉 0.05）. The incidence rate of the premature atrial contraction,premature ventricular contraction and atrial tachycardia in EH, CHD, EH ＋ CHD and healthy elderly subjects,there were much significant differences（ P 〈 0.01 ）. Except the incidence rate of premature atrial contraction there was significant difference between the patients in CHD and EH ＋ CHD （ P 〈 0.05） ,and no significant differences of the incidence rate of other kinds of arrhythmias in the patients with EH, CHD and EH ＋ CHD（P 〉 0.05）. Conclusion The autonomic never function of EH and CHD patients was dana- aged,and the incidence rate of arrhythmias was increased（the premature atrial contraction often happened, then the premature ventricular contraction）, and arrhymias happened in EH ＋ CHD patients is most oftenly. The vagal hypoaetivity and sympathetic hyperactivity were major causes of reduction of HRV and probable causes in the elderly patients.