高血压合并冠心病与单纯冠心病患者动态心电图心率变异性比较

Comparison of Heart Rate Variabilities in Dynamic Electrocardiogram between Patients with Hypertension Combined with Coronary Heart Disease and those with Simple Coronary Heart Disease

【目的】比较高血压合并冠心病与单纯冠心病患者动态心电图心率变异性(HRV)的差异。【方法】选取2020年1月至2022年6月本中心收治的83例老年高血压合并冠心病患者(观察组),另取本院同期收治的60例单纯老年冠心病患者(对照组)。比较两组临床基线资料、血生化指标[甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、空腹血糖(FPG)]和HRV时域参数[全部窦性心搏R-R间期标准差(SDNN)、相邻R-R间期差值均方根(RMSSD)、每5 min平均R-R间期标准差(SDANN)、相差>50 ms的相邻R-R间期占R-R间期总数百分比(pNN50)、每5 min窦性RR间期标准差均值(SDNN Index)]、HRV频域参数[低频功率(LF)、高频功率(HF)、低频功率/高频功率(LF/HF)]。【结果】两组患者TC、TG、LDL-C、HDL-C、FPG比较,差异均无统计学意义(P>0.05)。观察组HRV时域参数SDNN、RMSSD、SDANN、pNN50、SDNN Index低于对照组,差异有统计学意义(P<0.05)。观察组HRV频域参数LF、HF、LF/HF低于对照组,差异有统计学意义(P<0.05)。【结论】相较于单纯冠心病患者,高血压合并冠心病患者HRV时域参数及频域参数均明显降低,其自主神经功能紊乱也更为严重。

【Objective】To compare the differences of heart rate variabilities(HRV)in dynamic electrocardiography between patients with hypertension complicated with coronary heart disease and those with simple coronary heart disease.【Methods】A total of 83 elderly patients with hypertension complicated coronary heart disease admitted to our center from January 2020 to June 2022 were selected as the observation group,and 60 elderly patients with simple coronary heart disease admitted to our hospital during the same period were selected as the control group.Clinical baseline data,blood biochemical indicators[triglycerides(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),fasting blood glucose(FPG)],and HRV time-domain parameters[standard deviation of all sinus rhythm R-R intervals(SDNN),root mean square difference of adjacent R-R intervals(RMSSD),mean standard deviation of R-R intervals every 5 minutes(SDANN),percentage of adjacent R-R intervals with a difference of more than 50 ms to the total number of R-R intervals(pNN50),mean standard deviation of sinus RR intervals every 5 minutes(SDNN Index)],HRV frequency-domain parameters[low-frequency power(LF),high-frequency power(HF)]and low frequency power/high frequency power(LF/HF)were compared between the two groups.【Results】There were no statistically significant differences in TC,TG,LDL-C,HDL-C,and FPG between the two groups of patients(P>0.05).The time-domain parameters SDNN,RMSSD,SDANN,pNN50,and SDNN Index of HRV in the observation group were lower than those in the control group,and the difference was statistically significant(P<0.05).The frequency domain parameters LF,HF,and LF/HF of the observation group were lower than those of the control group,and the difference was statistically significant(P<0.05).【Conclusion】Compared with patients with simple coronary heart disease,hypertensive patients with coronary heart disease have significantly reduced HRV time-domain and frequency-domain parameters,and their autonomic nervous system dysfunction is more severe.