老年高血压患者同型半胱氨酸水平与心率变异的相关性

Correlative research on the level of homocysteine and heart rate variability in senile hypertension patients

目的探讨老年高血压患者同型半胱氨酸(Hcy)水平与心率变异(HRV)之间的关系。方法根据Hcy水平将106例高血压患者分为正常组和升高组2组。通过24 h动态心率变异性(HRV)频谱分析技术测定2组患者HRV,并与Hcy作相关性分析。结果 (1)与健康对照组相比,Hcy升高组的5 min平均心率的标准差、爱丁堡指数、正常R-R间期的标准差、相邻R-R间期之差的均方根值均偏低,两组数据差异有统计学意义(P<0.05);(2)Hcy升高组中频域分析指标:高频(HF)和低频(LF)低于健康对照组,差异有统计学意义(P<0.01),Hcy升高组中交感—迷走神经平衡指标(LF/HF)较正常组升高(P<0.05);(3)Hcy升高者HRV指数较正常组有所下降,空腹血糖、Hcy水平是心率变异危险因素(OR值分别1.57、1.37,P<0.05)。结论 Hcy升高是老年高血压患者自主神经病变的危险因素,对早期发现自主神经病变有益。

Objective To investigate the correlation of the level of homocysteine （Hcy） and heart rate varia- bility （HRV） for senile hypertension patients. Methods 106 hypertension patients were divided into the normal group and elevated group based on the level of Hcy. HRV of patients in both groups were detected with dynamic HRV frequency spectrum analysis technique for 24 hours, which was analyzed relatively combined with Hcy. Results （ 1 ） Patients in the elevated Hcy group were relatively low in the standard diviation of average NN intervals （SDANN） of 5 minutes, Edinburgh index （PNNS0）, standard diviation of NN intervals （SDNN） and root-mean-square deviation of R-R intervals （RMSSD） ,in comparison of those of patients in the normal group. There were statistical differences in the data of both groups （P 〈 0.05 ）. （2） High frequency （HF） and low frequency （LF） were lower in the elevated Hcy group compared with those in the normal control group, suggested by indexes of frequency-domain analysis, and differences of which indicated statistical significance （ P 〈 0.01 ） ; and LF and HF were higher in the elevated Hey group in comparison of those in the normal control group, demonstrated with balance indexes of sympathetic-vagus nerve （ P 〈 0.05 ）. （3） The HRV index of patients in the elevated Hcy group reduced relatively than that in the nor- real group. The risk factors of heart rate variability （SDNN） included fasting plasma glucose （FPG） and the level of Hcy;the values of odds ratio （OR） were 1.57 and 1.37（P〈0.05）. Conclusions Hey increase is an autonomic neuropathy-related risk factor, is beneficial to discover autonomic neuropathy for elderly hypertensive patients in the early stage.