并发不同常见慢性疾病的老年体位性低血压患者心率变异性的特点

Characteristics of heart rate variability in elderly orthostatic hypotensive patients with different common chronic disease states

目的探讨并发不同常见慢性疾病的老年体位性低血压患者心率变异性(HRV)的特点。方法将完善24小时动态心电图检查的267名60岁以上老年人分为体位性低血压组(OH组)和非体位性低血压组(非OH组),对两组患者HRV的时域和频域分别进行比较;同时,对这两组患者中并发不同的单一疾病患者的HRV指标分别进行分析比较。结果在非OH组,从时域性指标来看,高血压病最高,冠心病次之,糖尿病最低;从频域性指标来看,高血压病最高,糖尿病次之,冠心病最低。在OH组,从时域性指标来看,也是高血压病最高,冠心病次之,糖尿病最低;从频域性指标高频(HF)来看,也是高血压病最高,糖尿病次之,冠心病最低,但从低频(LF)来看,高血压病最高,冠心病和糖尿病差异不显著。与非OH组同病名同指标比较,OH组并发糖尿病的患者,时域性指标下降最为显著;OH组3种常见慢性病的频域性指标下降均很显著(P<0.05,P<0.01)。结论老年体位性低血压患者中,并发糖尿病患者时域性指标下降显著,并发冠心病患者频域性指标下降显著。

AIM To explore the characteristics of heart rate variability （HRV） in elderly orthostatic hypotension patients with different common chronic diseases. METHODS 267 long-term patients who were older than 60 years of age were devided into an orthostatic hypotension group （OH group） and non-orthostatic hypotension group （non-OH group）. After both groups completed a 24-hour-ambulatory ECG, HRV of time and frequency domain were compared between the two groups. Additionally, the HRV indexes of different patients with certain disease states were analyzed and compared. RESULTS In the non-OH group, from the time of the local indicators, hypertension was the highest, coronary heart disease was second, and diabetes mellitus was the lowest. With regard to frequency region, hypertension was the highest, diabetes mellitus was second, and coronary heart disease was the lowest. In the OH group, from the time locality index, high blood pressure was the highest, followed by coronary heart disease, and diabetes mellitus ws the lowest. According to the regional indicator HF, hypertension was the highest, and diabetes mellitus was second, with the lowest being coronary heart disease, but from LF, hypertension was the highest, and the difference between coronary heart disease and diabetes mellitus was not significant. Compared with those of the non-oh group and the indicators of disease, the OH group and patients with diabetes mellitus had the most significant decline in regional indicators. The frequency and regional indicators of 3 common chronic diseases in OH group were significantly decreased （P 〈 0. 05, P 〈 0. 01 ）. CONCLUSION In elderly patients with low blood pressure, there is a significant decrease in regional indicators in patients with diabetes mellitus and a significant decrease in frequency of patients with coronary heart disease.