摘要
目的研究高血压病患者血压达标情况与心率恢复(HRR)和心率变异性(HRV)的关系,以探讨血压达标对心脏自主神经功能的影响。方法将在心内科住院的高血压病患者121例(分为血压达标组70例和血压未达标组51例)进行回顾性分析,并对两组临床特征以及HRR和HRV各项指标进行分析。结果 (1)高血压病血压未达标组的吸烟发生率、钙拮抗剂使用和药物联合治疗比例均高于血压达标组(P<0.05)。(2)高血压病血压未达标组HRR、HRV中全程相邻RR间期差值的均方根(rMSSD)、全部相邻的RR间期差值>50 ms的百分数(pNN50)、极低频(VLF)、低频(LF)和高频(HF)值均低于血压达标组(P<0.01)。(3)两组HRR和HRV各指标在校正吸烟和钙拮抗剂使用的影响后,进行多因素logistic回归分析显示,rMSSD、pNN50、VLF、LF和HF降低是高血压病血压未达标的危险因素。结论高血压病患者血压未达标组的HRR和HRV降低更明显,高血压病血压未达标者自主神经功能受损更严重。
Objective To investigate the effect of blood pressure(BP) control on cardiac autonomic nervous function by researching the correlation between BP control and heart rate recovery(HRR) and heart rate variability(HRV) in hypertensive patients.Methods Hypertensive patients, who were hospitalized in the department of cardiology during October 2016 to September 2017, were grouped into controlled BP group(n=71) and uncontrolled BP group(n=50) for retrospective study. HRR, HRV and clinical characteristics of the two groups were analyzed.Results Smoker, calcium antagonist use and combined drug treatment were significantly higher in the uncontrolled BP group than in the controlled BP group(P<0.05). HRR and HRV values(rMSSD, pNN50, VLF, LF and HF) were significantly lower in the uncontrolled BP group than in the controlled BP group(P<0.01). Multiple logistic regression analysis showed that lower HRV values(rMSSD, pNN50, VLF, LF and HF) were risk factors for BP control of hypertension after adjusting for smoker and calcium antagonist use. Conclusion The present results demonstrate that uncontrolled BP is associated with lower HRR and HRV values, suggesting that impaired autonomic nerve function is more serious in patients with uncontrolled hypertension.
作者
吴师伟
余意君
顾力
徐艳玲
吴慧君
郑伟
周志云
邹武松
顾晔
WU Shi-wei;YU Yi-jun;GU Li;XU Yan-ling;WU Hui-jun;ZHENG Wei;ZHOU Zhi-yun;ZOU Wu-song;GU Ye(Wuhan Fourth Hospital,Puai Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430033,Hubei,China)
出处
《广东医学》
CAS
2019年第5期671-675,共5页
Guangdong Medical Journal
基金
武汉市临床医学科研项目(西医类)(编号:WX16D24)
关键词
高血压病
心率恢复
心率变异性
自主神经功能
hypertension
heart rate recovery
heart rate variability
autonomic nervous function
