单纯收缩期高血压患者心率变异性与颈动脉内膜厚度相关性研究

Relationship of heart rate variability and carotid intima-media thickness in patients with isolated systolic hypertension

目的:探讨单纯收缩期高血压(ISH)患者心率变异性(HRV)与颈动脉内膜厚度(IMT)的相关性。方法:选取164例轻中度高血压患者按血压特征分为单纯收缩期高血压(ISH,n=78)患者及双期高血压(DH,n=86)患者,采用动态心电分析系统分析HRV指数,采用颈动脉多谱勒超声检查IMT。比较两组间所测指标的差异性,并分析IMT与HRV各指标的相关性。结果:ISH组年龄、收缩压、脉压显著高于DH组而舒张压显著低于DH组(P<0.05),ISH组患者IMT显著高于DH组(P<0.05),HRV时域参数24h正常RR间期的标准差(SDNN),24h内5 min节段RR间期均值的标准差(SDANN),24h内5 min节段RR间期平均值标准差(SDNNindex),相邻RR间期差值的均方根(RMSSD)均显著低于DH组(P<0.05)。在ISH组患者中,校正年龄、脉压等影响后,IMT与SDNN(r=-0.29,P<0.01)、SDANN(r=-0.27,P<0.01)、SDNNindex(r=-0.32,P<0.01)、RMSSD(r=-0.35,P<0.01)呈负相关。在DH组患者中,IMI厚度与HRV各指标的相关系数无统计学意义(P>0.05)。结论:ISH患者具有IMT显著增高以及HRV显著降低的特点,且IMT与HRV密切相关。IMT与HRV可作为评价ISH患者心血管危险程度的重要指标,对其预后有重要意义。

Objective： To investigate the relationship of heart rate variability（HRV） and carotid in- tima-media thickness（IMT） in patients with isolated systolic hypertension（ISH）. Methods： A total of 164 patients with mild-moderate hypertension were enrolled and divided into isolated systolic hypertension （ISH） group （n=78） and double phase hypertension group （DH） （n=86）. HRV index were analyzed by Holter system, IMT were detected by Doppler Ultrasonography of carotid arteries. The results were com- pared, and correlation between HRV index and IMT were analyzed. Results. Age, systolic blood pressure, pulse pressure in ISH group were significantly higher, while diastolic blood pressure was significantly lower than that in DH group（all P〈0.05）. The mean thickness of IMT was larger in ISH group than that in DH group（P〈0.05）. The HRV index, including SDNN, SDANN, SDNN index and RMSSD in ISH group were significantly lower than that in DH group. IMT was significantly inverse correlated with SDNN（r=-0.29,P〈0.01）, SDANN（r=-0.27,P〈0.01）, SDNN index（r=-0.32,P〈0.01）and RMSSD（r=-O. 35,P〈0. 01）in ISH group, after adjusted for age and pulse pressure. However, the cor- relation were not significantly in DH group（P〉0.05）. Oonclusions, The thickness of IMT was increased, while HRV was significantly decreased in ISH. Furthermore, the IMT was significantly correlated with impairment of HRV. IMT and HRV assessment may be important in ISH for further risk stratification and prognosis.