高血压病患者心率与靶器官损害的相关性研究

目的分析高血压患者心率与靶器官损害之间的关系。方法高血压病患者262例,根据动态心电图记录的平均心率（HRV）将患者分为HR1（HRV〈70）、HR2（70≤HRV≤80、HR3 （HRV〉80）三组,每组根据收缩压水平、病程长短、年龄和糖尿病状况又分为若干亚组,以左心室质量指数（ILVMI）、双侧颈动脉内膜中层厚度（IMT）及尿微量白蛋白（MAU）作为高血压靶器官损害的观察指标,分析比较高血压患者心率与靶器官损害的相关性。结果（1）HR1、HR2和HR3三组间的LVMI、IMT水平均无显著性差异;（2）HR1、HR2和HR3三组MAU分别为37.47±65.27、56.85±79.63、93.70±102.45（mg/l）差异有显著性（P=0.002）,亚组间分析仍表现为心率快的患者MAU高。结论高血压患者尿微量白蛋白与心率呈正相关,且在糖尿病的血压较高、病程较长的患者中更为明显;高血压患者左心室质量指数、颈动脉内膜中层厚度受众多因素的影响,未发现与心率有相关性。

The Relationship between Heart Rate and Target Organs Damage in Essential Hypertension

[ Abstract] Objective To analyze the relationship between heart rate and target organs damage in essential hypertension. Methods 206 hypertensive patients were selected, According to HRV（bpm）recor- ded by Hoher, all the patients were divided into three following groups： HR1 （HRV 〈 70） , HR2 （70 ~〈 HRV ~〈80） and HR3 （ HRV 〉 80）. Moreover, every group was divided into some subgroups according to the blood pressure, history of hypertension, diabetes, and age respectively. To analyze and compare the relationship between heart rate and target organs damage in hypertensive patients, we selected LVMI, IMT and MAU as the target index. Results （ 1 ） There was no significant difference of LVMI and IMT among HR1, HR2 and HR3;（2） The difference of MAU （mg/l） among HR1, HR2 and HR3 was significant（ 37.47 ± 65.27, 56.85±79.63, 93.70± 102.45, P = 0. 002）. The analysis among subgroups also showed that the MAU was higher in the patient whose heart rate was faster. Conclusions The MAU is in positive correlation with heart rate in hypertensive patients , especially in long histoy patients with higher blood pressure and diabetes mellitus. We do not find LVMI and IMT relate with heart rate because they are influenced by many other factors in hypertensive patients.