摘要
目的:探讨冠心病(CHD)患者心率变异性(HRV)与血压昼夜节律(BPCR)变化及相关性.方法:选择2021年4月至2022年12月本院收治的118例CHD患者(CHD组)及80例健康体检者(健康组)作为研究对象,比较两组受试者HRV参数;根据夜间血压下降率将CHD患者分为非杓型组和杓型组,进一步分析比较两组患者BPCR参数以及HRV参数.结果:CHD组受试者HRV中的全部窦性R-R间期平方根(RMSSD)、全部窦性R-R间期标准差(SDNN)、两相邻R-R间期差值>50ms的百分数(PNN50)、每间隔5min窦性R-R间期的标准差(SDANN)水平低于健康组,差异有统计学意义(P<0.05).非杓型组患者夜间平均收缩压(nSBP)、夜间平均动脉压(nMAP)水平高于杓型组,SDNN和SDANN水平低于杓型组,差异有统计学意义(P<0.05);经Pearson相关性分析,白昼平均收缩压(dSBP)、白昼平均舒张压(dDBP)、白昼平均动脉压(dMAP)、nSBP、夜间平均舒张压(nDBP)及nMAP均与SDNN呈负相关,即随着血压的升高,HRV降低.结论:CHD患者HRV及BPCR均显著变化,且HRV与BPCR密切相关;夜间血压升高,会导致HRV下降,加重自主神经损伤,可采用动态心电图进行监测并予以及时干预.
Objective:To investigate the changes of heart rate variability(HRV)and blood pressure circadian rhythm(BPCR)and its correlation in patients with coronary heart disease(CHD).Methods:Collected 118 CHD patients(CHD group)and 80 healthy individuals(health group)from April 2021 to December 2022 in our hospital,HRV parameters were compared between the two groups.According to the decreasing rate of blood pressure at night,CHD patients were divided into non-arytenoid group and arytenoid group.BPCR parameters and HRV parameters of the two groups were analyzed and compared.Results:The levels of root mean square of successive RR interval differences(RMSSD),standard deviation of RR intervals(SDNN),percentage of adjacent NN intervals differing by more than 50 milli seconds(PNN50)and the standard deviation of all 5-min mean normal RR intervals(SDANN)in CHD group were lower than those in healthy group(P<0.05);The levels of night time systolic blood pressure(nSBP)and night time mean arterial pressure(nMAP)in the non-dipper group were higher than those in the dipper group,while the levels of SDNN and SDANN were lower than those in the dipper group(P<0.05);Pearson correlation analysis showed that daytime SBP(dSBP),daytime diastolic blood pressure(dDBP),daytime MAP(dMAP),nSBP,nDBP and nMAP were all negatively correlated with SDNN,that was,HRV decreased with the increase of blood pressure.Conclusions:HRV and BPCR both changed significantly in CHD patients,and HRV wasclosely correlated to BPCR,the increased blood pressure at night will lead to the decrease of HRV and aggravate autonomic nerve injury,so dynamic electrocardiogram can be used for monitoring and timely intervention.
作者
邱丹丹
王健
张楠
QIU Dan-dan;WANG Jian;ZHANG Nan(Department of Electrocardiogram,the First People's Hospital of Zhumadian,Zhumadian 463000,China)
出处
《四川解剖学杂志》
2023年第3期23-25,41,共4页
Sichuan Journal of Anatomy
关键词
冠心病
动态心电图
心率变异性
血压昼夜节律
Coronary heart disease
Dynamic electrocardiogram
Heart rate variability
Circadian rhythm of blood pressure
