青年高血压患者静息心率与颈动脉结构关系的研究

Relationship between resting heart rate and carotid artery structure in young hypertensive patients

目的 探讨青年高血压患者静息心率与颈动脉结构的关系.方法 选择2009年1月至2012年1月新疆医科大学第一附属医院高血压科663例年龄在18～45（38.01±5.78）岁的青年原发性高血压住院患者.按每分钟静息心率水平分为3组：A组（＜70次,n=163）,B组（70次≤心率＜80次,n=268）,C组（≥80次,n=232）.超声检查双侧颈动脉内膜中层厚度和动脉内径,观察颈动脉血管壁斑块发生情况;对比各组颈动脉结构相关参数,进行方差分析和双变量相关分析.结果 （1）3组患者入院时SBP、DBP总体差异均有统计学意义（P＜0.01）,A组DBP高于B组（P＜0.05）,C组SBP和DBP高于B组（P＜0.01）;（2）3组患者颈动脉结构比较,右侧颈动脉内径A组高于C组（P＜0.05）,左侧颈动脉内径A组高于B组（P＜0.05）,左侧颈动脉内径A组高于C组（P＜0.05）;（3）静息心率与入院SBP、DBP在0.01水平（双侧）上显著正相关（r值分别为0.112、0.118）,而与左颈动脉内径在0.05水平（双侧）上显著负相关（r=-0.89）,与右侧颈动脉内径呈负相关,但相关性不甚密切（r=-0.075,P=0.068）.结论 青年高血压患者静息心率增快可出现血压增高、颈动脉内径减少的趋势.

Objective To investigate the relationship between resting heart rate （RHR）and carotid artery structure in young hypertensive patients.Methods A total of 663 primary hypertensive patients aged between 18 and 45 （38.01 ± 5.78） were chosen from the First Affiliated Hospital of Xinjiang Medical University from January,2009 to January,2012.Patients under this study were divided into three groups according to their RHRs：group A （RHR〈70 bpm,n=163）,group B（70 bpm≤RHR〈80 bpm,n=268）,group C （RHR≥80 bpm,n=232）.Data on bilateral carotid artery intima-media thickness,common carotid artery diameter were detected by carotid ultra-sonography.Indexes of carotid artery were analyzed by both variance and bi-variate correlation analysis.Results 1）Differences in the blood pressure among three groups showed statistical significance （P〈0.01）,with diastolic pressure in group A higher than in group B （P〈0.05）,while both systolic and diastolic pressure in group C higher than in group B （P〈0.01）.2）In group A,the right carotid artery diameter was higher than in group C（P〈0.05） and the left carotid artery diameter higher than in group B（P〈 0.05） with the left carotid artery diameter higher than in group C （P〈0.05）.3） Significant positive correlations were found between RHR and blood pressure （r =0.112,0.118） and negative correlation between RHR and left carotid artery diameter （r=-0.89）.However,correlation between RHR and right carotid artery diameter was not significant （r=-0.075,P=0.068）.Conclusion When blood pressure had an increase,we found that the carotid artery diameter was decreasing along with the increasing RHR among the young hypertensive patients.