肾实质性高血压和原发性高血压心率变异性对照分析

目的探讨肾实质性高血压和原发性高血压患者动态心电图心率变异性。方法记录肾实质性高血压患者（A组。n=67）、原发性高血压患者（B组，n=82）、健康人（C组，n=60）24h动态心电图心率变异性（HRV）情况，并进行了统计分析。结果3组相邻R—R（NN）间期的平均值总体标准差分别为（71．4±8．7）ms、（92．7±15．4）ms和（140．5±34．8）ms，24h每连续5min相邻R—R问期标准差的平均值分别为（51．5±11．4）ms、（79．4±14．6）ms和（126．4±31．6）ms，全程记录每5min相邻R—R间期平均值的标准差分别为（29．4±8．1）ms、（35．7±11．6）ms和（45．7±13．1）ms。相邻R—R问期差值的均方根分别为（17．5±4．3）ms、（21．6±7，8）ms和（26．2±9．5）ms，相邻R—R间期差值：〉50ms的个数均值分别为2，7±1．9、5．6±2．1和11．2±3．4。3组间及每两组间比较差异均有统计学意义（P〈0．05）。结论肾实质性高血压患者心率变异性（HRV）较原发性高血压明显下降。

A Comparative Analysis of Heart Rate Variability in Patients with Renal Hypertension and Essential Hypertension

Objective To investigate ambulatory heart rate variability in patients with renal hypertension and essential hypertension. Methods The heart rate variability was measured based on 24-hour dynamic electrocardiogram （DCG） in patients with renal hypertension （group A, n = 67）, essential hypertension （group B, n = 82） and healthy individuals （group C, n = 60）. Results The standard deviation（SD） of normal-to-normal（NN） intervals was 71.4 ± 8.7ms,92.7 ± 15.4 ms and 140.5 ± 34.8ms, SD of the averages of NN intervals in all 5-minute segments of DCG 51.5 ± 11.4ms, 79.4 ± 14.6ms and 126.4 ± 31.6ms, mean of SD of NN intervals for all consecutive 5-minute segments of DCG 29.4 ± 8.1ms,35.7 ± 11.6ms and 45.7 ± 13.1ms, root mean square of successive differences 17.5 ± 4.3ms, 21.6 ± 7.8ms and 26.2 ± 9.5ms, and the percent of differences between adjacent NN intervals 〉 50 ms 2.7 ± 1.9, 5.6 ± 2.1and11.2 ± 3.4, respectively, in group A, B and C. There were significant differences among three groups and between every two groups （P 〈0.05）. Conclusion Heart rate variability decreases more significantly in patients with renal hypertension than with essential hypertension.