老年高血压患者心率变异与靶器官损害的相关性研究

An analysis of heart rate variability in elderly essential hypertension

目的探讨老年高血压患者心率变异（HRV）与靶器官损害的关系。方法选取老年高血压患者210例，其中单纯高血压组4l例，高血压伴左室肥厚（LVH）患者65例、伴肾功损害者53例、伴颈动脉IMT增厚患者51例；选择健康者50名作为对照组，进行心率变异性时域分析。对人选者做以下检查：心电图、超声心动图、24h动态心电图、颈动脉内膜-中层厚度（IMT）、血肌酐。结果老年高血压患者HRV各项指标低于对照组（P〈0．05）；高血压伴LVH组HRV与单纯高血压组比较，差异有统计学意义（P〈0．01）.高血压伴肾功损害及IMT增厚者HRV与单纯高血压组比较，差异有统计学意岁。’P〈0．05）。结论老年高血压靶器官损害患者的HRV减低，即自主神经对心脏的调节能力减弱；可通过自主神经功能受损程度来评估靶器官受损的程度和判断预后。

Objective To investigate the characteristics of heart rate variability （HRV） in elderly pa- tients with hypertension and their correlation with target organ damage. Methods Selected 210 cases of elderly patients with hypertension, 41 cases of simple hypertension, 65 hypertensives with LVH, 53 hypertensives with renal damage, and 51 hypertensives with thickening of carotid IMT, 50 cases of healthy persons as control group. HRV was analysed in time-domain. ECG, echocardiography, Holter ECG. carotid artery intima-media thickness （IMT） and serum creatinine were measured at the same time. Results HRV levels in elderly hypertensives were significantly lower than in the normal control groups （P〈0.01）. Compared with the control group, HRV in hyper- tensives with LVH, and in patients with renal damage and IMT thickening were significantly difference （P〈0.05）. Conclusion HRV decreases in elderly hypertensive patients with target organ damage, namely, the autonomic nervous regulation of the heart is decline. The extent of target organ damage and prognosis may be estimated by the autonomic nervous system damage.