高血压患者静息心率和心率昼夜节律分析的临床意义

Clinical Significance of Resting Heart Rate and Heart Rate Circadian Rhythm in Patients with Hypertension

目的探讨静息心率和心率昼夜节律变化对不同高血压患者的临床意义。方法选择我院2010年7月至2012年10月临床确诊的高血压患者113例,根据昼夜间的心率均值情况,划分为构型心率组和非构型心率组,分别为55例和58例。所有患者均进行24h不间断的动态血压和心电监测。统计两组患者AHR、NHR、RHR,以及昼夜间的LF和HF,分析静息心率和心率昼夜节律对于不同高血压患者的临床意义。结果非构型心率组的AHR、NHR和RHR分别为76±10、73±9、73±12,与构型心率组相比,均具有统计学差异,P<0.05。非构型HR组患者心率>70次/min有45例,占比为77.6%;≤70次/min患者13例,占比为22.4%。两组患者昼夜LF和HF均有统计学差异,P<0.05。就组间相比来看,非构型心率组无论是白天还是夜间,其LF和HF与构型心率组相比均有统计学差异,P<0.05。结论通过观察不同高血压患者的静息心率和心率昼夜节律情况,可以更好地了解其神经受损状况,促进患者的治疗。

Objective To explore the clinical significance of resting heart rate and heart rate circadian rhythm change in patients with hypertension. Methods 113 patients with hypertension in our hospital from July 2010 to October 2012 were selected and divided into two groups according to the mean circadian rhythm： configuration heart rate group （n = 55） and non configuration heart rate group （n = 58）. All patients received the 24-hour dynamic blood pressure and electrocardiogram monitoring. The AHR, NHR, RHR and LF, HF during day and night were summarized to analyze the clinical significance of resting heart rate and heart rate circadian rhythm. Results The AHR, NHR and RHR were 76 ±10, 73 ± 9, 73 ± 12 in non configuration rate group respectively, which had statistical differences compared with the configuration rate group （P 〈0.05）. 45 cases （77.6%） had the heart rate 〉70/min, and 13 cases （22.4%） ~〈70/min in the non configuration rate group. The differences of RHR, LF, HF during day and night between two groups were statistically significant （P〈0.05）. The differences of LF and HF between day and night was statistically significant （P 〈0.05）. Conclusions Through the observation of the resting heart rate and heart rate circadian rhythm, we can better understand the patients＇ nerve damage condition, and promote treatment.