柯尔克孜族与汉族体位性血压变异患者的心率变异性差异

Difference of heart rate variability between the Kirgiz and Han nationality Chinese patients with postural blood pressure variability

目的比较柯尔克孜族与汉族体位性血压变异(PBPV)患者的心率变异性(HRV)差异。方法测量柯尔克孜族人群88例(A组)和汉族人群102例(B组)卧位及改为直立位3 min内血压值,据此将两组分为有PBPV患者(A1组25例,B1组43例,血压变化≥10 mmHg)和非PBPV患者(A2组63例,B2组59例)4个亚组。24-h动态心电图监测并分析各组的HRV相关指标。结果A1组男性患者比例大于B1组(P<0.05)。与A2组比较,A1组SDNN、SDNN5、TRIA、SDANN、RMSSD均有降低趋势,但差异无统计学意义(P>0.05)。与B2组比较,B1组SDNN、SDNN5、PNN50、TRIA、SDANN、RMSSD均降低(P<0.05)。与B1组比较,A1组SDNN、TRIA、SDANN、RMSSD降低,但差异无统计学意义(P>0.05)。与B2组比较,A2组SDNN、SDNN5、PNN50、TRIA、RMSSD降低(P<0.05)。结论HRV能反映自主神经在体位性血压调节中的作用,对PBPV患者自主神经病变的诊断、治疗及预后有较高的临床应用价值。

Objective To compare the difference of heart rate variability(HRV)between the Kirgiz and Han nationality Chinese patients with postural blood pressure variability(PBPV).Methods The blood pressure values of 88 Kirgiz people(group A)and 102 Han people(group B)were measured on the supine position and changed as a orthostatic position within 3 minutes.According to the postural change of blood pressure,groups of A and B were subdivided into groups of A1(with postural blood pressure change≥10 mmHg,25 cases),A2(with postural blood pressure change<10 mmHg,63 cases),B1(with postural blood pressure change≥10 mmHg,43 cases)and B2(with postural blood pressure change<10 mmHg,59 cases).24-h Holter recording was used to analyze the HRV of the four subgroups.Results The percentage of male peopole in group A1was higher than that in group B1(P<0.05).Compared with group A2,the values of SDNN,SDNN5,TRIA,SDANN and RMSSD in group A1 were slightly lower(P>0.05).The values of SDNN,SDNN5,PNN50,TRIA,SDANN and RMSSD were less in group B1 than those in group B2(P<0.05).Compared with group B1,the values of SDNN,TRIA,SDANN and RMSSD were slightly lower in group A1(P>0.05).The values of SDNN,SDNN5,PNN50,TRIA and RMSSD were lower in group A2 than those in group B2(P<0.05).Conclusion HRV can reflect the role of autonomic nerves system in the orthostatic blood pressure regulation and has a better clinical value in the diagnosis,treatment and prognosis of autonomic neuropathy in the patients with PBPV.