原发性高血压病患者交感神经和迷走神经张力对静息心率的影响

Effects of sympathetic nerve and vagal nerve tension on resting heart rate in patients with essential hypertension

目的分析原发性高血压病患者交感神经和迷走神经张力对静息心率的影响。方法选择2018年6月至2019年6月新乡市中心医院收治的120例原发性高血压病患者为研究对象,根据静息心率将患者分为A组(静息心率<60次·min^-1)、B组(静息心率60~75次·min^-1)和C组(静息心率>75次·min^-1),每组40例。所有患者进行24 h动态心电图检测,对各组患者极低频带(VLF)、低频带(LF)、高频带(HF)、心率减速力(DC)、LF/HF比值进行比较。结果3组患者VLF、LF、HF、DC、LF/HF比值比较差异有统计学意义(P<0.05);A组患者VLF、LF、HF、DC值显著高于B组和C组(P<0.05);B组患者VLF、LF、HF、DC值显著高于C组(P<0.05);C组患者LF/HF比值显著高于A组和B组(P<0.05);A组患者LF/HF比值与B组比较差异无统计学意义(P>0.05)。静息心率与VLF、LF、HF、DC呈负相关(P<0.05),与LF/HF比值呈正相关(P<0.05)。结论静息心率为60~75次·min^-1的原发性高血压病患者静息心率主要受迷走神经紊乱影响,静息心率>75次·min^-1的原发性高血压病患者静息心率主要受交感神经紊乱影响。

Objective To analyze the effect of sympathetic nerve and vagal nerve tension on resting heart rate(RHR)in patients with essential hypertension.Methods A total of 120 patients with essential hypertension who were hospitalized in Central Hospital of Xinxiang City from June 2018 to June 2019 were selected as the research subjects.According to different levels of RHR,the patients were divided into group A(RHR<60 times per minute),group B(RHR of 60-75 times per minute)and group C(RHR>75 times per minute),with 40 patients in each group.All patients underwent the test of 24-hour ambulatory electrocardiogram,and the very low frequency band(VLF),low frequency band(LF),high frequency band(HF),heart rate deceleration(DC)and LF/HF ratio of patients were compared among the three groups.Results There were statistically significant differences in the VLF,LF,HF,DC and LF/HF ratio among the three groups(P<0.05);the VLF,LF,HF and DC values of patients in the group A were significantly higher than those in the group B and group C(P<0.05);the VLF,LF,HF and DC values of patients in the group B were significantly higher than those in the group C(P<0.05);the LF/HF ratio in the group C was significantly higher than that in the group A and the group B(P<0.05);there was no significant difference in the LF/HF ratio between the group A and the group B(P>0.05).RHR was negatively correlated with VLF,LF,HF and DC(P<0.05),and it was positively correlated with LF/HF ratio(P<0.05)Conclusion The RHR of essential hypertensive patients with RHR of 60-75 times per minute is mainly affected by vagus nerve disorder,while that of essential hypertensive patients with RHR more than 75 times per minute is mainly affected by sympathetic nerve disorder.