心率变异性与高血压患者早期肾损害的相关性研究

Heart Rate Variability and Early Renal Damage in Patients with Hypertension :A Correlation Study

目的探讨心率变异性与高血压患者早期肾损害的相关性。方法 100例高血压患者分为高血压伴肾功能损害组(A组)和单纯高血压组(B组),同时收集50例正常人作为对照组,观察各组的心率变异性、动态心电图以及肾功能相关指标,并对各指标之间的相关性进行分析。结果 A和B组的SDNN、SDANN、RMSSD和PNN50均显著低于对照组,且A组SDNN、SDANN、RMSSD和PNN50均显著低于B组,差异有统计学意义(P<0.05);A和B组各时段的SBP、DBP均显著高于对照组,而相应的△MBP均显著低于对照组,差异有统计学意义(P<0.05);A组各时段的SBP、DBP均显著高于B组,而相应的△MBP均显著低于B组,差异有统计学意义(P<0.05);A组的血β2-MG和Cyst-C以及尿RBC、mALB、β2-MG、UAER和NAG水平均显著高于B组和对照组,而GFR水平则显著低于B组和对照组,差异有统计学意义(P<0.05)。直线相关分析显示,HRV各指标与尿mALB、β2-MG、UAER、NAG和Cyst-C均呈显著负相关(r分别是-0.45、-0.39、-0.52、-0.38和-0.25,均P<0.05)。结论 HRV与高血压患者早期肾损害的一些指标之间存在明显的相关性,有助于及时诊断高血压病早期肾损害。

Objective To study the correlation between HRV and early renal damage in patients with hypertension. Methods One hundred patients with hypertension were divided into two groups according to the hypertension accompanied by renal damage group （ A group ） and simple hypertension group （B group）, then took 50 health adults as control group, the heart rate variability, Holter and relevant indicators of renal function were observed and the correlation among the indexes were analyzed. Results The SDNN, SDANN, RMSSD and PNN50 of A and B group were significantly lower than control group, and the SDNN, SDANN, RMSSD and PNNSO of A group were significantly lower than B group and with there was a significant difference （ P 〈 0.05 ） ; the SBP and DBP of A and B group in each time were significantly higher than control group, while the corresponding A MBP were significantly lower than control group, with there was a significant difference （ P 〈 0.05 ） ; the SBP and DBP of A group in each time were significantly higher than B group, while the corresponding a MBP were significantly lower than B group with there was a significant difference （ P 〈0.05 ） ; the blood β2-MG and Cyst-C and urinary RBC, mALB, β2-MG, UAER and NAG of A group were significantly higher than B group and control group, while GFR levels were significantly lower than B group and control group with there was a significant difference （ P 〈 0.05 ） Linear correlation analysis showed： Indexes of HRV showed significant negative correlation to mALB, UAER, NAG and Cyst-C levels （ r were -0.45, -0.39,-0.52, -0.38 and -0.25, all P〈 0.05 ）. Conclusion There exists a significant correlation between heart rate variability and early renal damage in patients with hypertension and it is helpful for the timely diagnosis of early renal damage in patients with hypertension.