静息心率对中青年原发性高血压及靶器官损害影响的研究
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摘要
目的：探讨静息心率(resting heart rate RHR)与中青年原发性高血压的关系及其对高血压危险因素和靶器官损害的影响。方法：入选原发性高血压患者144例,同期健康体检者160例。分别检测两组入选人员的RHR,比较两组之间RHR的差异。高血压组按RHR水平分为三组,RHR1组：RHR1<70bpm, RHR2组：70bpm≤RHR<80 bpm, RHR3组：RHR≥80bpm。测量高血压患者血压、身高、体重、血糖、血脂、颈动脉内膜中层厚度等,统计高血压患者合并靶器官损害的人数,对三组RHR间高血压危险因素及靶器官损害进行对比,分析差异有无统计学意义。结果：(1)高血压组RHR (78.10±9.019bpm)高于对照组RHR(70.81±10.278bpm)(P<0.05)。高血压患者的舒张压随RHR的增快而增高,三组之间比较有统计学差异(P<0.05),而收缩压三组间比较未见明显差异(P>0.05)。(2)RHR与高血压危险因素体重指数、空腹血糖呈正相关,其相关系数为(r=0.259,P<0.01；r=0.19,P<0.05),与甘油三酯、总胆固醇、高密度脂蛋白、低密度脂蛋白间无相关性(P>0.05)。(3)RHR增加可促进高血压靶器官损害的发生(P<0.05),RHR增加的高血压患者其颈动脉内膜厚度增高(P<0.05)。RHR2组和RHR3组的颈动脉内膜均高于RHR1组(P<0.01), RHR与颈动脉内膜中层厚度呈正相关性(r=0.237,P<0.01)。结论：RHR增快与中青年原发性高血压有一定相关性,提示RHR增快可作为高血压患者估测靶器官损害的一项参考指标。
Objective:To explore the relationship between the resting heart rate (RHR) and the hypertension, and the influence to the risk factors and the damage of target organs in essential hypertension of middle and young subjects. Methods:There were 144 hypertension patients in hypertension group and 160 healthy subjects in control group, testing the RHR and comparing the difference in the hypertension group and the control group. According to the level of the RHR meassured by electrocardiography in the hypertension group, they were divided into three groups:RHR1(<70bpm), RHR2 (70bpm80bpm) and systolic blood pressure (SBP), diastolic blood pressure(DBP), body mass index(BMI), fasting plasma glucose, blood fat and carotid intimal medial thickness were examined. Then count the case of the damage of target organs. The results of different groups'made contrast and correlation each other. Results:(1) The level of the RHR in hypertensive group was significantly higher than that in normal group (78.10±9.02bpm vs 70.81±10.28bpm,P<0.05). DBP in all groups showed a statistically significant difference (P<0.05), and increased with RHR increasing. But SBP has no significant difference in the three groups (P>0.05). (2) Correlation analysis showed that RHR was positively correlated with BMI(r=0.259,P<0.01),and also had positively correlated with FPG,(r=0.19, P<0.05); but the RHR didn't have correlated with TG, TC, HDL-C,LDL-C(P>0.05).(3)In essential hypertension patients, the proportion of complications of the hypertension was different in different RHR groups, RHR higher, the bigger the proportion of complications (P<0.05). CIMT increased with the RHR increasing. The difference of CIMT among RHR1, RHR2, RHR3 were significant (P<0.01), Compared with RHR1 group, the RHR2 group and RHR3 group presented higher levels of CIMT (P<0.01). There was significant positive correlation between RHR and CIMT in hypertensive group(r=0.237, P<0.01). conclusions:RHR was correlated to the level of hypertension, RHR was one of the risk factors to middle and young patients with essential hypertension, and was used as one of the indicators for screening target organ damage in hypertension.
Objective:To explore the relationship between the resting heart rate (RHR) and the hypertension, and the influence to the risk factors and the damage of target organs in essential hypertension of middle and young subjects. Methods:There were 144 hypertension patients in hypertension group and 160 healthy subjects in control group, testing the RHR and comparing the difference in the hypertension group and the control group. According to the level of the RHR meassured by electrocardiography in the hypertension group, they were divided into three groups:RHR1(<70bpm), RHR2 (70bpm
引文
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[9]雷宇春,王忠勇.青年人高血压病临床特点分析[J].人民军医,2003,46,(11)：630-631.
[10]翟献节,董霞.青壮年高血压患者遵医行为现状调查[J].南方护理学报,2005,(9)：19-21.
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[12]何秉贤.高血压防治的严峻形势和存在问题[J].中华高血压杂志,2007,15(4)：268.
[13]李立明,饶克勤,孔灵芝,等.中国居民2002年营养与健康状况调查[J].中华流行病学杂志,2005,26(7)：478-484.
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[15]赵秀丽,陈捷,崔艳丽,等.中国14省市高血压现状的流行病学研究[J].中华医学杂志,2006,16：1148-1152.
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