高血压伴室性早搏患者心率变异性与心率震荡现象的相关性

Correlation between heart rate turbulence and heart rate variability in patients with hypertension and concomitant ventricular premature beat

目的:探讨高血压伴室性早搏患者的心率变异性(HRV)与心率震荡(HRT)现象的相关性。方法:选择2009年1月至2011年12月在北京市第六医院综合内科就诊的原发性高血压患者360例作为研究对象,根据有无伴发室性早搏分为高血压伴发室性早搏组(200例)和单纯高血压组(160例),并选择同期健康人群120例作为对照组。记录分析3组HRV、HRT的各项指标。结果:高血压伴室性早搏组、单纯高血压组TO、TS与对照组比较,差异均有统计学意义(P<0.05)。高血压伴室性早搏组TO、TS与单纯高血压组患者比较,差异有统计学意义(P<0.05)。高血压伴室性早搏组与单纯高血压组患者SDNN、rMSSD、PNN_(50)、T_1检测结果均低于对照组(P<0.05)。高血压伴室性早搏患者TO与SDNN、rMSDD值呈负相关(P<0.05),TS与SDNN、rMSDD值呈正相关(P<0.05)。结论:高血压伴室性早搏患者自主神经功能系统受损较单纯高血压患者严重,HRV、HRT与高血压伴室性早搏存在相关性,可作为评估指标。

Objective：To investigate the correlation between heart rate turbulence （HRT）and heart rate variability （HRV） in patients with hypertensive and concomitant ventrieular premature beats （ VPB ）. Methods： Between January 2009 and December 2011, we recruited 360 patients with primary hypertension from the department of general medicine,Beijing No. 6 Hospital,who were allocated to hypertension plus VPB group （n = 200）and hypertension group （n = 160）based on the presence of concomitant VPB. 120 consecutive normal subjects were allocated to control group. The HRV and HRT indices were analyzed. Results： Compared with control group, both hypertension and hypertension plus VPB group yielded significantly different TO and TS（ both P 〈 0.05 ）. Hypertension plus VPB group also had considerably different TO and TS compared with hypertension group（ both P 〈 0.05 ）. Compared with control group, markedly reduced SDNN,rMSSD, PNNs0 and T1 were found in hypertension group and hypertension plus VPB group（ all P 〈 0.05 ）. In hypertension plus VPB group, TO was negatively correlated with SDNN and rMSDD（ both P 〈 0.05 ） , which were positively correlated TS（ both P 〈 0. 05 ）. Conclusion：Patients with hypertension and concomitant VPB may be characterized by significantly impaired autonomous nervous function. HRV and HRT are associated with VPB in hypertension and could be employed as the indices for assessment.