冠心病合并高血压患者心率变异与颈动脉内中膜厚度的关系研究

Relationship Between Heart Rate Variation and Carotid Intima-media Thickness in Patients with Coronary Heart Disease and Hypertension

目的本文主要探讨冠心病合并高血压患者心率变异(HRV)与颈动脉内中膜厚度(IMT)的关系。方法选取2018年5月至2019年5月兰州市西固区人民医院收治的单纯高血压患者85例,作为单纯高血压组,以及同期收治的冠心病合并高血压患者150例患者为冠心病合并高血压组,采用动态心电图评定心率变异性,应用彩色多普勒超声测量颈动脉内中膜厚度,进而分析冠心病合并高血压患者心率变异与颈动脉内中膜厚度的关系。结果冠心病合并高血压患者组总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、小而密低密度脂蛋白胆固醇(sdLDL-C)、空腹血糖(FPG)水平都明显偏高,差异有统计学意义(P<0.05)。冠心病合并高血压患者组心率变异时域各项指标均显著降低,差异有统计学意义(P<0.05)。TC、TG、LDL-C、sdLDL-C、FPG与颈动脉内中膜厚度(IMT)呈正相关,HDL-C、24 h内每5 min正常R-R间期的平均值标准差(SDANN)、相邻正常R-R间期差值的均方根值(rMSSD)、相邻R-R间期差值大于50 ms的个数占总窦性心搏数的百分比(pNN50)与IMT呈负相关。结论通过检测IMT和HRV的值预测高血压患者冠心病风险,进而预防心血管事件的发生,对冠心病的防治具有重要意义。

Objective To investigate the relationship between heart rate variability and carotid intima-media thickness in patients with coronary heart disease and hypertension.Methods From May 2018 to May 2019,85 patients with simple hypertension admitted to Lanzhou Xigu District People's Hospital were selected as the simple hypertension group,and 150 patients with coronary heart disease complicated with hypertension were selected as the research objects.Heart rate variability was evaluated by dynamic electrocardiogram,and carotid intimamedia thickness was measured by color Doppler ultrasound,and then the relationship between heart rate variability and carotid artery intima-media thickness was analyzed.Results Total cholesterol(TC),triglycerides(TG),low-density lipoprotein cholesterol(LDL-C),small dense(sdLDL-C),and fasting plasma glucose(FPG)levels were significantly higher in the CHD plus hypertension group(P<0.05).The time domain indexes of heart rate variability in patients with coronary heart disease and hypertension were significantly decreased,the difference was statistically significant(P<0.05).The correlation analysis showed that TC、TG、LDL-C、sdLDL-C,FPG were positively correlated with IMT,HDL-C,SDANN,rMSSD,pNN50 were negatively correlated with IMT.Conclusion The detection of IMT and HRV can predict the risk of coronary heart disease in patients with hypertension,and then prevent the occurrence of cardiovascular events,which is of great significance for the prevention and treatment of coronary heart diseas.