并发不同常见慢性疾病的老年体位性低血压患者心率变异性的特点
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摘要
目的探讨并发不同常见慢性疾病的老年体位性低血压患者心率变异性(HRV)的特点。方法将完善24小时动态心电图检查的267名60岁以上老年人分为体位性低血压组(OH组)和非体位性低血压组(非OH组),对两组患者HRV的时域和频域分别进行比较;同时,对这两组患者中并发不同的单一疾病患者的HRV指标分别进行分析比较。结果在非OH组,从时域性指标来看,高血压病最高,冠心病次之,糖尿病最低;从频域性指标来看,高血压病最高,糖尿病次之,冠心病最低。在OH组,从时域性指标来看,也是高血压病最高,冠心病次之,糖尿病最低;从频域性指标高频(HF)来看,也是高血压病最高,糖尿病次之,冠心病最低,但从低频(LF)来看,高血压病最高,冠心病和糖尿病差异不显著。与非OH组同病名同指标比较,OH组并发糖尿病的患者,时域性指标下降最为显著;OH组3种常见慢性病的频域性指标下降均很显著(P<0.05,P<0.01)。结论老年体位性低血压患者中,并发糖尿病患者时域性指标下降显著,并发冠心病患者频域性指标下降显著。
AIM To explore the characteristics of heart rate variability( HRV) in elderly orthostatic hypotension patients with different common chronic diseases. METHODS 267 long-term patients who were older than 60 years of age were devided into an orthostatic hypotension group( OH group) and non-orthostatic hypotension group( non-OH group). After both groups completed a 24-hour-ambulatory ECG,HRV of time and frequency domain were compared between the two groups. Additionally,the HRV indexes of different patients with certain disease states were analyzed and compared. RESULTS In the non-OH group,from the time of the local indicators,hypertension was the highest,coronary heart disease was second,and diabetes mellitus was the lowest. With regard to frequency region,hypertension was the highest,diabetes mellitus was second,and coronary heart disease was the lowest. In the OH group,from the time locality index,high blood pressure was the highest,followed by coronary heart disease,and diabetes mellitus ws the lowest. According to the regional indicator HF,hypertension was the highest,and diabetes mellitus was second,with the lowest being coronary heart disease,but from LF,hypertension was the highest,and the difference between coronary heart disease and diabetes mellitus was not significant. Compared with those of the non-oh group and the indicators of disease,the OH group and patients with diabetes mellitus had the most significant decline in regional indicators. The frequency and regional indicators of 3 common chronic diseases in OH group were significantly decreased( P < 0. 05,P < 0. 01). CONCLUSION In elderly patients with low blood pressure,there is a significant decrease in regional indicators in patients with diabetes mellitus and a significant decrease in frequency of patients with coronary heart disease.
AIM To explore the characteristics of heart rate variability( HRV) in elderly orthostatic hypotension patients with different common chronic diseases. METHODS 267 long-term patients who were older than 60 years of age were devided into an orthostatic hypotension group( OH group) and non-orthostatic hypotension group( non-OH group). After both groups completed a 24-hour-ambulatory ECG,HRV of time and frequency domain were compared between the two groups. Additionally,the HRV indexes of different patients with certain disease states were analyzed and compared. RESULTS In the non-OH group,from the time of the local indicators,hypertension was the highest,coronary heart disease was second,and diabetes mellitus was the lowest. With regard to frequency region,hypertension was the highest,diabetes mellitus was second,and coronary heart disease was the lowest. In the OH group,from the time locality index,high blood pressure was the highest,followed by coronary heart disease,and diabetes mellitus ws the lowest. According to the regional indicator HF,hypertension was the highest,and diabetes mellitus was second,with the lowest being coronary heart disease,but from LF,hypertension was the highest,and the difference between coronary heart disease and diabetes mellitus was not significant. Compared with those of the non-oh group and the indicators of disease,the OH group and patients with diabetes mellitus had the most significant decline in regional indicators. The frequency and regional indicators of 3 common chronic diseases in OH group were significantly decreased( P < 0. 05,P < 0. 01). CONCLUSION In elderly patients with low blood pressure,there is a significant decrease in regional indicators in patients with diabetes mellitus and a significant decrease in frequency of patients with coronary heart disease.
引文
[1]Mader SL.Orthostatic hypotension in older patients[J].Aging Health,2016,2(3):505-513.
[2]孙瑞龙,吴宁,杨世豪,等.心率变异性检测临床应用的建议[J].中华心血管病杂志,1998,26(4):252-255.
[3]Low PA,Tomalia VA.Orthostatic Hypotension:Mechanisms,Causes,Management[J].J Clin Neurol,2015,11(3):220-226.
[4]Brunton S.Pathophysiology of Type 2 Diabetes:The Evolution of Our Understanding[J].J Fam Pract,2016,65(4 Suppl).pii:suppaz-0416.Reveiw.
[5]Khandoker AH,Al-Angari HM,Khalaf K,et al.Association of Diabetes Related Complications with Heart Rate Variability among a Diabetic Population in the UAE[J].Plos One,2017,12(1):e0168584.
[6]田国平,谭振清.冠心病患者心率变异性与冠状动脉病变的关系[J].实用医学杂志,2008,24(10):1720-1722.
[7]Jordan J.Pathophysiology of hypertension:What are our current concepts?[J].Der Internist,2015,56(3):219-223.
[8]庞胜峰,何胜虎.二甲双胍对原发性高血压合并糖耐量降低患者心率变异性影响及其机制探讨[J].实用医学杂志,2014(21):3502-3504.
[9]Arnold AC,Shibao C.Current concepts in orthostatic hypotension management[J].Curr Hypertens Rep,2013,15(4):304-312.
[10]Meng L,Wen ZY,Endocrinology DO.Effect of Exenatide on Serum Oxidative Stress and Heart Rate Viability in Diabetic Autonomic Neuropathy Patients[J].Medical Recapitulate,2013,19(18):3383-3386.
[2]孙瑞龙,吴宁,杨世豪,等.心率变异性检测临床应用的建议[J].中华心血管病杂志,1998,26(4):252-255.
[3]Low PA,Tomalia VA.Orthostatic Hypotension:Mechanisms,Causes,Management[J].J Clin Neurol,2015,11(3):220-226.
[4]Brunton S.Pathophysiology of Type 2 Diabetes:The Evolution of Our Understanding[J].J Fam Pract,2016,65(4 Suppl).pii:suppaz-0416.Reveiw.
[5]Khandoker AH,Al-Angari HM,Khalaf K,et al.Association of Diabetes Related Complications with Heart Rate Variability among a Diabetic Population in the UAE[J].Plos One,2017,12(1):e0168584.
[6]田国平,谭振清.冠心病患者心率变异性与冠状动脉病变的关系[J].实用医学杂志,2008,24(10):1720-1722.
[7]Jordan J.Pathophysiology of hypertension:What are our current concepts?[J].Der Internist,2015,56(3):219-223.
[8]庞胜峰,何胜虎.二甲双胍对原发性高血压合并糖耐量降低患者心率变异性影响及其机制探讨[J].实用医学杂志,2014(21):3502-3504.
[9]Arnold AC,Shibao C.Current concepts in orthostatic hypotension management[J].Curr Hypertens Rep,2013,15(4):304-312.
[10]Meng L,Wen ZY,Endocrinology DO.Effect of Exenatide on Serum Oxidative Stress and Heart Rate Viability in Diabetic Autonomic Neuropathy Patients[J].Medical Recapitulate,2013,19(18):3383-3386.