摘要
目的:研究高血压伴不同水平颈动脉内膜中层厚度(IMT)患者心率震荡(HRT)现象及安体舒通的干预效应。方法:选择原发性高血压患者184例,根据IMT,分为IMT1组(IMT≤1.0)、IMT2组(1.0<IMT<1.3)和IMT3组(IMT≥1.3),根据是否服用安体舒通,各组又分为基础治疗组和安体舒通治疗组,利用24h动态心电图获得其室性期前收缩,分别计算治疗前及治疗6个月后不同分组的震荡初始(TO)和震荡斜率(TS)。结果:3种不同水平IMT高血压患者TO值和TS值均存在不同程度异常,TO值IMT3组>IMT2组>IMT1组(P<0.01);TS值IMT3组<IMT2组<IMT1组(P<0.01)。与治疗前比较,治疗后3组中基础治疗组和安体舒通组TO值均显著降低,TS值均显著升高(均P<0.01);协方差分析显示,扣除治疗前TO和TS的影响后,比较其校正均数,安体舒通治疗较基础治疗能进一步降低IMT2组和IMT3组的TO值(F=9.56,F=8.32,均P<0.01),升高其TS值(F=14.81,F=9.45,均P<0.01),而在IMT1组中,安体舒通组治疗和基础治疗对TO及TS的影响无统计学意义。结论:高血压伴IMT增厚患者HRT明显减弱,IMT增厚越明显,HRT异常越严重,安体舒通可改善高血压伴IMT增厚患者的HRT现象。
Objective：To study the effect of antisterone on change of heart rate turbulence（HRT）in hypertension patients with different levels of carotid intima-media thickness（IMT）.Method：The 184 patients with essential hypertension were divided into IMT1group（IMT≤1.0）,IMT2 group（1.0IMT1.3）and IMT3group（IMT≥1.3）,according to the carotid intima-media thickness.Each group was randomly divided into control sub-group with the basis treatment and antisterone sub-group with the treatment of antisterone and the basis treatment.The ventricular premature beat was captured before treatment and after six months treatment by 24 hdynamic electrocardiography.Then turbulence onset（TO）and turbulence slope（TS）of the each group was calculated respectively. Result：TO and TS were abnormal in three different levels of IMT in patients with essential hypertension.TO in IMT3IMT2IMT1（P0.05）,and TS in IMT3IMT2IMT1（P0.05）.After six months treatment,TO was significantly decreased and TS was significantly increased both in basis treatment sub-group and antisterone sub-group in all patients.Covariance analysis displayed that the changes of TO（F=9.56,F=8.32,respectively P0.01）and TS（F=14.81,F=9.45,respectively P0.01）in antisterone sub-group were significantly higher than the basis treatment sub-group both in IMT2 and IMT3respectively,but these was no significantly change in IMT1.Conclusion：HRT is relation to its levels of carotid intima-media thickness in patients with essential hypertension.The more carotid intima-media thickness can be caused,the more serious anomaly in HRT can be found in these patients.Antisterone can improve HRT in IMT2 and IMT3patients with essential hypertension,but cannot improve it in IMT1 patients.
出处
《临床心血管病杂志》
CAS
CSCD
北大核心
2013年第11期867-870,共4页
Journal of Clinical Cardiology
关键词
高血压
心率震荡
颈动脉内膜中层厚度
安体舒通
hypertension
heart rate turbulence
carotid intima-media thickness
antisterone
