原发性高血压患者心律失常检测及心率变异性分析

Analysis of arrhythmia and heart rate variability of primary hypertension patients

目的研究原发性高血压患者的心律、心率与心率变异性。方法采用24h动态心电图(Holter)评价331例门诊高血压患者的心律失常情况;并分析202例患者心率变异性(HRV)的时域和频域指标。结果331例患者均为窦性心律,心律失常检出率达93%。房性心律失常检出率(87%)远高于室性心律失常(50%),房性早搏≤100个/24h占全部房性早搏者的95%,室性早搏≤100个/24h者占全部室性早搏者的85%,10%的患者合并有短暂房性心动过速,室性心动过速发生率为0.9%,II度II型房室传导阻滞3%。各项时域参数值较正常参考值低,高频(HF)、低频(LF)成份亦低于正常参考值,而LF/HF则明显高于正常参考值。结论原发性高血压患者的心律失常具高发生率且广谱的特性,房性心律失常最为多见,HRV明显降低。

Objective To study the rhythm,heart rate and heart rate variability （HRV） of primary hypertension patients. Methods 24 hours Hoher was employed to evaluate heart rate and rhythm of 331 primary hypertension patients. Analyze HRV of 202 cases. Results 100% patients were discovered having sinus bradycardia, 93% with atrial and ventricular arrhythmia. The frequency of artrial arrhythmia （87%） was higher than that of ventricular arrhythmia （50%）. In the total atrial extrasystole patients, 95% were less than 100beats/24h and 85% as for ventricular extrasysrole. About 10% patients had atrial tachycardia and 0.9% of ventricular tachycardia. No atrial fibrillation, type Ⅱ second-degree AV block was seen in 3% patients. The HRV analysis indicated that SDNN,rMSSD,PNN50 and HF decreased whereas LF/HF increased. Conclusion The arrhythmia in hypertensive patients represents high frequency and wide spectrum, with supreventricular extrasystole as the most common form. HRV decreases in hypertenion.