高血压病患者心率变异的变化及其与室性心律失常的相关性研究

The change of heart rate variability in patients with primary hypertension and its relationship with ventricular arrhythmia

目的探讨高血压病(EH)者24h心率变异性(HRV)的变化及其与室性心律失常(VA)的关系。方法采用动态心电图(DCG)记录96例患者(A组)和40例对照者(B组)的24h心电信号,分析其HRV变化及其与VA的发生情况。结果EH者HRV各项时域指标和频域指标中的LF、VLF、HF均较B组显著降低,并有随着VA程度的加重而降低的趋势;时域指标中的SDNN、SDANN、ASDNN、PNN50与VA程度呈弱负相关(P<0.05);SDANN为EH者VA的保护因素。结论EH者HRV明显降低,HRV与EH者VA程度呈弱负相关。SDANN为EH者VA的保护因素。早期对自主神经功能紊乱进行干预治疗,可能有利于减少EH者VA的发生。

Objective To investigate the change of heart rate variability（HRV） in patients with primary hypertension and its relationship with ventricular arrhythmia. Methods The parameters of HRV and ventricular arrhythmia were measured by 24 - hour ambulatory electrocardiogram in 96 patients with primary hypertension and compared with that in 40 normal control subjects. Results Both time and frequency domain indexes（LF,VLF,HF） had a decreasing trend with the worsening of ventricular arhythmia. There was a weak negative corelation between time domain indexes （SDNN, SDANN, ASDNN or PNN50） and ventricular arhythmia （P 〈 0.05 ）. The result of logistic regression indicates that SDANN was a protective factor. Conclusion There is weak negative corelation between HRV and the severity of ventrietdar arhythmia in patients with primary hypertension. SDANN is a protective factor of ventricular arrhythmia. It is favour of reducing the incidence of ventricular arrhythmia by earlier interfere of autonomic nerves disorder.