原发性高血压患者动态脉压与心率减速力和心率变异性的相关性
摘要
目的探讨原发性高血压患者动态脉压(PP)与心率减速力(DC)和心率变异性(HRV)的相关关系。方法就诊我科的原发性高血压患者180例均给予动态血压检查,根据动态血压检测结果,按照动态PP水平分为三组:将24h平均PP<40mmHg的患者作为PP1组(n=60)、将24h平均PP在40～60mmHg之间的患者作为PP2组(n=60)、将24h平均PP<60mmHg的患者作为PP3组(n=60)。同时选取60例健康人作为健康对照组。分析计算所有研究对象DC值和HRV时域指标总体标准差(SDNN)、差值均方根(rMSSD)和大于50ms百分比(pNN50),比较各组患者DC和HRV时域指标并进行各指标之间相关性分析。结果原发性高血压患者DC值和HRV时域指标SDNN、rMSSD、pNN50数值水平均较健康对照组降低(P<0.01),且随着PP增高而出现降低趋势(P<0.05); DC和HRV时域指标SDNN、rMSSD、pNN50呈正相关(r=0.25～0.48,P<0.05);动态PP与DC和HRV时域指标SDNN、rMSSD、pNN50均呈负相关(r=-0.15～-0.68,P<0.05)。结论原发性高血压患者动态PP与DC和HRV时域指标呈负相关,DC和HRV时域指标呈正相关;原发性高血压患者自主神经功能受损程度与动态PP正相关。
引文
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[11]张超,孙骏,张志琴,等.炎症状态与原发性高血压患者动态脉压的关系[J].中华高血压杂志,2009,17(2):171-172.
[2]郭继鸿.心率减速力检测[J],临床心电学杂志,2009,18(1):59-68.
[3]杨卫东.脉压增大对高血压心血管事件预测的临床作用分析[J].中国实验诊断学,2014,18(10):1691-1692.
[4]Bauer A,Kantelhardt JW,Barthel P,et al.Deceleration capacity o heart rate as a predictor of mortality after myocardial infarction:cohor study[J].Lancet,2006,367(9523):1674-1681.
[5]徐峰,王宁,刘金尧,等.老年高血压病人血压动态变化与心率变异性的关系[J].中国老年学杂志,2011,31(23):4516-4517.
[6]Al-Zaiti SS,Pietrasik G,Carey MG,et al.The role of heart rate variability,heart rate turbulence,and deceleration capacity in predicting cause specific mortality in chronic heart failure[J].J Electrocardiol,2018,6(52):70-74.
[7]张钦凤,朴,高尚伯,等.脉压与心脑血管病的关系:一个大样本的随访研究[J].中华高血压杂志,2006,14:830-832.
[8]Schaeffer BN,Rybczynski M,Sheikhzadeh S,et al.Heart rate turbulence and deceleration capacity for risk prediction of serious arrhythmic events in Marfan syndrome[J].Clin Res Cardiol,2015,104(12):1054-1063.
[9]Lewek J,Wranicz JK,Uzik P,et al.Clinical and electrocardiographic covariates of deceleration capacity in patients with ST-segment elevation myocardial infarction[J].Cardiol J,2009,16(6):528-534.
[10]郭继鸿.连续心率减速力测定[J].临床心电学杂志,2012,21(3):227-233.
[11]张超,孙骏,张志琴,等.炎症状态与原发性高血压患者动态脉压的关系[J].中华高血压杂志,2009,17(2):171-172.