关于高血压患者窦性心率震荡的研究

目的：观察原发性高血压患者血压水平及左室肥厚与窦性心率震荡（HRT）的关系及临床意义.方法：125例原发性高血压患者行24h动态血压、动态心电图及心脏彩超检查,测得24h平均血压、震荡初始（TO）、震荡斜率（TS）及左室质量指数（LVMI）.根据结果患者被分为血压1、2、3级三组（46例、41例、38例）和无左室肥厚（74例）、左室肥厚（51例）两亚组,比较各组患者的TO和TS值.结果：TO值：高血压3级组TO值显著大于高血压2级及1级组（-0.87±1.14）％比（-1.86±1.19）％比（-2.48±1.75）％],且高血压2级组显著大于高血压1级组（P＜0.05～＜0.01）；左室肥厚组较无左室肥厚组TO值（1.08±1.19）％比（-0.15±0.45）％]显著增大,差异有统计学意义（P＜0.01）.TS值：高血压3级组TS值显著小于高血压2级及1级组（1.55±1.06） ms/RR间期比（2.33±1.48） ms/RR间期比（3.76±1.87） ms/RR间期],且高血压2级组显著小于高血压1级组（P＜0.05～＜0.01）；左室肥厚组较无左室肥厚组TS值（3.02±1.08）ms/RR间期比（4.76±1.75）ms/RR间期]显著减小,差异有统计学意义（P＜0.01）.结论：原发性高血压患者血压越高,心率震荡异常越显著,合并左室肥厚者较无左室肥厚者心率震荡异常显著；心率震荡有助于判断预后,指导治疗.

Study of sinus heart rate turbulence for hypertensive patients with different level of blood pressrue

Objective：To observe the relationship among blood pressure,left ventricular hypertrophy （LVH） and sinus heart rate turbulence （HRT） in patients with essential hypertension （EH） and its clinical significance.Methods：A total of 125 EH patients received 24h ambulatory blood pressure monitoring,dynamic electrocardiogram and echocardiography examination in order to measure 24h mean blood pressure,turbulence onset （TO）,turbulence slope （TS） and left ventricular mass index （LVMI）.According to 24h mean blood pressure,patients were divided into hypertension stage 1 group （n=46）,stage 2 group （n=41） and stage 3 group （n=38） ; according to LVMI,patients were divided into non-LVH group （n=74） and LVH group （n=51）.TO and TS were compared among all groups.Results：TO：Compared with hypertension stage 1 and stage 2 group,there was significant increase in TO （-2.48±1.75）% vs.（-1.86±1.19） %vs.（-0.87±1.14） %] in hypertension stage 3 group,and that of stage 2 group was significantly higher than that of stage 1 group （P〈0.05～〈0.01）;compared with non-LVH group,there was significant increase in TO （-0.15±0.45） % vs.（1.08±1.19） %] in LVH group,P〈0.01.TS：compared with hypertension stage 1 and stage 2 group,there was significant decrease in TS （3.76± 1.87） ms/RR interval vs.（2.33±1.48） ms/RR interval vs.（1.55±1.06） ms/RR interval] in hypertension stage 3 group,and that of stage 2 group was significantly lower than that of stage 1 group （P〈0.05～〈0.01）; compared with non-LVH group,there was significant decrease in TS （4.76± 1.75） ms/RR interval vs.（3.02 ± 1.08） ms/RR interval] in LVH group,P〈0.01.Conclusion：The higher the blood pressure is,the more abnormality the heart rate turbulence is;the heart rate turbulence abnormality of patients complicated with LVH is more severe than that of non-LVH patients in patients with essential hypertension,so heart rate turbulence is help to judge prognosis and guide treatment.