原发性高血压患者醛固酮/肾素比值与心率变异性和QT间期的关系研究

Correlation study between ratio of aldosterone to renin and heart rate variability,QT interval in patients with essential hypertension

目的探讨高血压患者醛固酮/肾素比值(ARR)与心率变异性(HRV)及QT间期的相关性。方法选取研究对象179例,根据ARR中位数分为ARR低值组和ARR高值组,比较2组24 h动态心电图(Holter)、24 h动态血压(ABPM)、常规心电图、血清钾、血清钠等,比较2组的HRV、QT间期等指标以及相关性。结果 2组Holter中的SDNN、SDNN Index、SDANN Index、RMSSD以及QTc、血钾、血钠有显著差异(P<0.05)。校正相关因素后,ARR与SDNN、SDNN Index、SDANN Index、RMSSD、血钾呈负相关(r=-0.444、-0.677、-0.381、-0.623、-0.432,P<0.05),与QTc、血钠呈正相关(r=0.391、0.379,P<0.05)。多因素Logistic回归分析显示,SDNN、SDNN Index、SDANN Index均是ARR的独立相关因素(P<0.05)。结论原发性高血压患者中醛固酮高与心率变异性减少密切相关。

ObjectiveTo study the correlation between aldosterone/renin ratio （ARR） and heart rate variability （HRV）, QT interval in patients with essential hypertension. MethodsA total of 179 people were divided into two groups according to median number of ARR, and 24 h Holter, 24 h ambulatory blood pressure, ECG, serum potassium, serum sodium were monitored, then HRV and QT interval index were compared between the two groups. ResultsThere were significant differences between the two groups in SDNN, SDNN index, SDANN index, RMSSD, QTc, blood potassium, sodium （P〈0.05）, while gender, age, diabetes, smoking, BMI, average heart rate, heart rate standard deviation showed no significant difference. At the same time, correction factors showed that ARR was still negatively correlated with SDNN, SDNN Index, SDANN Index, RMSSD, serum potassium （r=-0.444, -0.677, -0.381, -0.623, -0.432, P〈0.05）, and was positively correlated with QTc , serum sodium （ r = 0. 391 ,0. 379 ,P 〈0.05） . Multivariate logistic regression analysis showed that SDNN , SDNN Index , SDANN Index were the independent factors related to ARR （P 〈 0. 05 ） . Conclusion High aldosterone is closely related to heart rate variability reduction.