颈动脉内-中膜厚度与心率变异的相关性研究

Correlation between Intima-media Thickness of Carotid Artery in Color Ultrasonography and Heart Rate Variability

目的探讨颈动脉内-中膜厚度(IMT)与心率变异(HRV)的相关性。方法将2013年3月-5月住院的34例心血管疾病患者纳入疾病组(其中单纯冠心病11例、单纯高血压病13例、两种疾病合并者10例为再次按疾病类型分为各亚组),30例非心血管疾病患者纳入对照组,回顾性分析各组间颈动脉IMT与24 h动态心电图HRV相关指标的相关性。结果疾病组、合并组、冠心病组和高血压病组IMT均厚于对照组,差异有统计学意义(P<0.05)。HRV相比,仅合并组的24 h正常RR间期标准差(SDNN)、24 h内5 min节段正常RR间期均值标准差(SDANN)低于对照组(P<0.05)。疾病组内-中膜增厚(IMT≥1.0 mm)23例,其中合并组8例,冠心病组10例,高血压病组5例,高于对照组的2例(P<0.05),但疾病组HRV降低(SDNN<100 ms)18例,包括合并组7例、冠心病组6例、高血压病组5例,与对照组11例相比均无统计学意义(P>0.05)。疾病组IMT与SDNN、SDANN呈负相关(r=-0.574、-0.544,P<0.01),对照组IMT仅与SDANN呈负相关(r=-0.392,P<0.05)。结论心血管疾病患者颈动脉病变、自主神经尤其是交感神经功能损害明显,两者呈负相关。

Objective To investigate the correlation between intima-media thickness（IMT） of carotid artery in color ultrasonography and the heart rate variability. Methods A retrospective analysis was performed in 64 patients from West China Hospital of Sichuan University between March and May 2013. Carotid intima-media thickness was measured with color ultrasonography and dynamic electrocardiogram, and the heart rate variability was assayed at the same time. Results IMT in the cardiovascular disease group, combination group, coronary heart disease group and hypertension group was signifi cantly thicker than the control group（P〈 0.05）. The differences of SDNN and SDANN were statistically signifi cant（P〈 0.05） between the combination group and the control group. There were 23 cases with IMT ≥ 1.0 mm in the cardiovascular disease group including 8 cases in the combination group, 10 cases in the coronary heart disease group and 5 cases in the hypertension group. IMT in those groups were all significantly higher than that in the control group with only 2 cases having IMT ≥ 1.0 mm（P〈 0.05）. There were 18 cases with SDNN 〈100 ms in the cardiovascular disease group including 7 cases in the combination group, 6 cases in the coronary heart disease group and 5 cases in the hypertension group, but there was no statistically signifi cant difference compared with that in the control group with only 11 cases（P 〉0.05）. Negative correlation was found between IMT and SDNN, SDANN in the cardiovascular diseases group（r=-0.574,-0.544; P〈 0.01） and negative correlation was found between IMT and SDANN in the control group（r=-0.392, P 〈0.05）. Conclusion The carotid artery lesions and autonomic nerve especially sympathetic nerve dysfunction are obvious in patients with cardiovascular diseases and there is a negative correlation between them.