高血压病并发冠心病患者的心率变异性与心律失常分析

目的 探讨高血压病并发冠心病患者的自主神经活动和心律失常的特点.方法 对52例原发性高血压(EH)患者、44例冠心病(CHD)患者和56例EH并发CHD患者与34例健康老年人的心率变异性(HRV)进行对比研究.结果 EH组和CHD组与对照组HRV时域法所有参数差异均有显著性(P＜0.05);EH并发CHD组与对照组比较,各参数差异均有非常显著意义(P＜0.01);但不同疾病组间比较,差异均无显著性(P＞0.05).3个疾病组与对照组比较,房性早搏、房性心动过速和室性早搏的发生率均有极显著性差异(P＜0.01);而EH组、CHD组及EH CHD组间,除外CHD组与EH CHD组房性早搏的发生率有显著性差异外(P＜0.05),其余差异均无显著性.结论 高血压病患者和冠心病患者的自主神经功能受损,心律失常发生率增加(以房性早搏最常见,其次为室性早搏);当高血压病患者并发冠心病时这种受损更加明显,其迷走神经张力降低,交感神经紧张性相对增高是导致老年患者心率变异性降低的主要原因和心律失常的可能因素.

Analysis of heart rate variability and arrhythmias in the patients with essential hypertension and coronary heart disease

Objective To study autonomic nerve regulator character and arrhythmias in the patients with essential hypertension(EH)and coronary heart disease(CHD).Methods The heart rate variability(HRV)and arrhythmias in 52 EH,44 CHD,56 EH+CHD patients and 34 health elderly subjects were investigated.Results There were significant difference of HRV in the patients with EH,CHD and healthy elderly subjects(P<0.05),There were much significant difference of HRV in the patients with EH+CHD and healthy elderly subjects(P<0.01),but no significant difference of HRV in the patients with EH and CHD(P>0.05).The incidence rate of the premature atrial contraction,premature ventricular contraction and atrial tachycardia in EH,CHD,EH+CHD and healthy elderly subjects,there were much significant difference(P<0.01).Except the incidence rate of premature atrial contraction there were significant difference between in CHD and in EH+CHD(P<0.05),no significant difference of the incidence rate of other kinds of arrhythmias in the patients with EH and CHD and EH+CHD(P>0.05).Conclusion The autonomic never function of EH and CHD patients were damaged,and the incidence rate of arrhythmias was increased(the premature atrial contraction often happened,then the premature ventricular contraction),and arrhymias happened in EH+CHD patients is most oftenly.The vagal hypoactivity and sympathetic hyperactivity were major causes of reduction of HRV and probable causes in the elderly patients.