H型高血压合并急性脑梗死患者心率变异性和靶器官功能情况及其相关性分析

目的 本研究旨在探讨H型高血压合并急性脑梗死患者心率变异性、靶器官功能情况及其相关性分析。 方法 自2016年1月-2017年1月,前瞻性收集丽水市妇幼保健院收治的高血压合并急性脑梗死患者92例,根据患者入院时同型半胱氨酸(homocysteine,Hcy)水平,分为观察组42例(Hcy ≥ 10 mmol)和对照组50例(Hcy<10 mmol/L),观察2组患者心率变异性和靶器官功能损伤情况。 结果 与对照组比较,观察组患者SDNN、SDANN、SDNN-Index、PNN50(%)均显著降低(P<0.05)。2组患者rMSSD差异无统计学意义(P>0.05)。观察组颈动脉内膜中膜厚度、动脉硬化指数、冠心病指数、胱抑素C、24 h收缩压变异性均显著高于对照组(P<0.05)。Pearson线性相关性分析显示SDNN、SDANN、PNN50(%)与颈动脉内膜中膜厚度(IMT)、胱抑素C和24 h收缩压变异性均呈负相关(均P<0.05)。SDNN-Index与胱抑素C、24 h收缩压变异性呈负相关(均P<0.05)。rMSSD与IMT、动脉硬化指数、冠心病指数、胱抑素C和24 h收缩压变异性等无明显相关性(均P>0.05)。 结论 H型高血压合并急性脑梗死患者心率变异性降低、器官功能损伤较为严重,心率变异性降低可能与患者靶器官功能损伤有关。 

Heart rate variability and target organ damage in patients with H-type hypertension complicated with acute cerebral infarction and their correlations

Objective To investigate the heart rate variability and target organ damage in patients with H-type hypertension complicated with acute cerebral infarction and their correlations. Methods From January, 2016 to January, 2017, 92 patients with hypertension complicated with cerebral infarction were prospectively collected in our hospital. According to the level of homocysteine (Hcy) on admission, all patients were assigned into observation group (Hcy ≥ 10 mmol, n=42) or control group (Hcy < 10 mmol/L, n=50). The heart rate variability and organs damage of the both groups were observed. Results When compared with the control group, the patients in the observation group got decreased level of SDNN, SDANN, SDNN-Index and PNN50 (%), P<0.05. There was no significant difference between the two group in rMSSD (P>0.05). The intima media thickness, arteriosclerosis index, coronary artery disease index, Cystatin C and 24 h systolic pressure variability in the observation group were significantly higher than those in the control group (P<0.05). Pearson linear correlation analysis showed that SDNN, SDANN and PNN50 (%) were negatively correlated with intimia-media thickness (IMT), cystatin C and 24 h systolic pressure variability (P<0.05); SDNN-Index was negatively related to cystatin C and 24 h systolic pressure variability (P<0.05). There was no significant correlation between rMSSD and IMT, arteriosclerosis index, coronary artery disease index, Cystatin C and 24 h systolic blood pressure variability (P>0.05). Conclusion Patients with H-type hypertension complicated with acute cerebral infarction get decreased heart rate variability and worse target organs functions, the decrease of heart rate variability may be related to the impairment of target organ function.