原发性高血压患者24 h动态心电图心率减速力与心率变异性的相关性研究

目的探讨原发性高血压(EH)患者心率减速力(DC)特点,分析其与心率变异性(HRV)各时域指标的相关性,以及对自主神经功能的评估价值。方法前瞻性选择2018年1月至2020年6月合肥市滨湖医院收治的78例EH患者,作为EH组。另选取同期体检的50位健康志愿者,作为对照组。2组均接受24 h动态心电图监测,比较2组DC值和HRV时域指标窦性R-R间期标准差(SDNN)、差值均方根(RMSSD)和相邻R-R间期差值>50 ms心搏百分比(pNN50)];依据DC值进行猝死危险分层,将EH组分为高危组(DC≤2.5 ms)和非高危组(DC≥2.6 ms)比较2组HRV时域指标差异;分析DC与HRV各时域指标的相关性。结果EH组DC、SDNN、RMSSD、pNN50分别为(4.83±1.27)ms、(109.26±21.03)ms、(38.74±9.38)ms、(5.12±0.95)%,均明显低于对照组的(6.19±1.42)ms、(132.07±28.54)ms、(52.65±11.32)ms、(7.83±1.42)%,差异均有统计学意义(P<0.05);高危组DC、SDNN、RMSSD、pNN50分别为(2.42±0.07)ms、(87.39±10.23)ms、(32.57±8.15)ms、(4.26±1.02)%,均明显低于非高危组的(5.27±1.26)ms、(113.24±20.15)ms、(39.86±10.47)ms、(5.28±1.27)%,差异均有统计学意义(P<0.05);Pearson法分析显示,EH患者DC与SDNN、RMSSD、pNN50水平均呈正相关(r=0.637、0.652、0.709,P<0.05)。结论EH患者DC明显下降,且和HRV呈正相关,可协同作为自主神经功能和猝死风险的评估筛查指标。

Correlation study between heart rate deceleration force and heart rate variability in 24 h ambulatory electrocardiogram in patients with essential hypertension

Objective To explore the characteristics of heart rate deceleration(DC)in patients with essential hypertension(EH),analyze its correlation with heart rate variability(HRV)indicators in various time domains,and evaluate the value of autonomic nervous function.Methods The 78 patients with EH admitted to Hefei Binhu Hospital from January 2018 to June 2020 were prospectively selected as the EH group.In addition,50 healthy volunteers who received physical examination during the same period were selected as the control group.The DC value and HRV time domain indexesstandard deviation of R-R intervals(SDNN),root mean square of essential difference(RMSSD)and percentage of heart beats with difference between adjacent R-R intervals>50 ms(pNN50)]were compared between the two groups.The EH group were divided into high-risk group(DC≤2.5 ms)and non high-risk group(DC≥2.6 ms),the differences of HRV time domain indexes between were compared,and the correlation between DC and HRV was analyzed.Results The DC,SDNN,RMSSD,and pNN50 of the EH group were(4.83±1.27)ms,(109.26±21.03)ms,(38.74±9.38)ms,(5.12±0.95)%,respectively,which were significantly lower than those of the control group(6.19±1.42)ms,(132.07±28.54)ms,(52.65±11.32)ms,(7.83±1.42)%,the differences were statistically significant(P<0.05);the high-risk group DC,SDNN,RMSSD,pNN50 were(2.42±0.07)ms,(87.39±10.23)ms,(32.57±8.15)ms,(4.26±1.02)%,which were significantly lower than those of the non-high-risk group(5.27±1.26)ms,(113.24±20.15)ms,(39.86±10.47)ms,(5.28±1.27)%,the differences were statistically significant(P<0.05);Pearson analysis showed that DC was positively correlated with SDNN,RMSSD,pNN50 in EH patients(r=0.637,0.652,0.709,P<0.05).Conclusion DC in EH patients decreased significantly,and was positively correlated with HRV.The consistency of autonomic nervous function assessment was good,which can be used as a screening indicator of sudden death risk in EH patients.