冠心病合并高血压患者心率变异性分析

The Analysis of Heart Rate Variability in Coronary Heart Disease Patients with Hypertension

目的研究分析冠状动脉粥样硬化性心脏病(冠心病)合并不同级别高血压患者心率变异性的特点。方法收集2013年7月至2014年5月在安徽医科大学第二附属医院诊断为冠心病的患者173例,依据是否合并高血压及高血压分级情况进行分组,其中单纯冠心病(A组)43例,合并高血压Ⅰ级(B组)45例,合并高血压Ⅱ级(C组)44例,合并高血压Ⅲ级(D组)41例,患者均行24 h动态心电图监测,统计各组患者心率变异性时域指标,包括NN间期标准差(SDNN)、NN间期平均值标准差(SDANN)、NN间期标准差均值(ASDNN),分析各组数据间差异。结果 SDNN、SDANN和ASDNN在A、B、C、D四组分别为(122±20)ms、(109±19)ms、(99±16)ms、(87±13)ms,(110±18)ms、(96±17)ms、(85±14)ms、(76±13)ms及(67±12)ms、(58±10)ms、(50±9)ms、(43±8)ms,两两比较显示,A组各指标高于B、C、D组,B组各指标高于C、D组,C组各指标高于D组,差异均有统计学意义(P<0.05)。结论冠心病合并高血压患者的自主神经功能紊乱较单纯冠心病患者更加严重,随着高血压病等级增高,心率变异性降低,临床应引起重视。

Objective To study the characteristics of heart rate variability（HRV） in coronary heart dis-ease（ CHD） patients with different grades of hypertension.Methods Admitted into the Second Affiliated Hospital of Anhui Medical University, from Jul.2013 to May 2014, 173 cases diagnosed as CHD, were grouped according to whether complicated with hypertension and hypertension classification , into only CHD group（ group A） of 43 cases, hypertension grade 1 group（ group B） of 45 cases,hypertension grade 2 group （group C） of 44 cases,hypertension grade 3 group（group D） of 41 cases, all subjects underwent 24 hours dynamic electrocardiogram,then the HRV data in different groups, including standard deviation of NN inter-vals（SDNN）,standard deviation of the average NN intervals,SDANN（SDANN）,and average of the standard deviation NN intervals（ ASDNN） were statistically recorded and analyzed.Results The SDNN,SDANN and ASDNN of group A,B,C,D were （122 ±20） ms,（109 ±19） ms,（99 ±16） ms,（87 ±13） ms,（110 ± 18） ms,（96 ±17） ms,（85 ±14） ms,（76 ±13） ms,and （67 ±12） ms,（58 ±10） ms,（50 ±9） ms, （43 ±8） ms respectively,the level of each index in group A was higher than the others,and the level in group B was higher than those in group C and D ,the level in group C was higher than those in group D ,and the differences were statistically significant（P〈0.05）.Conclusion The dysfunction of heart autonomic in CHD patients with hypertension was more serious than CHD patients without hypertension , and the higher grade hypertension the higher the severity,therefore due clinical attention should be aroused.