原发f生高血压合并早发冠心病患者心率震荡分析

目的探讨原发性高血压合并早发冠心病患者心率震荡（HRT）的特点及其与单纯高血压病、单纯冠心病患者HRT的差异。方法将124例住院患者根据冠脉造影结果、实验室检查、心脏超声检查、血压等分为正常对照组、高血压组、冠心病组和高血压合并冠心病组（合并组），4组均行24h动态心电图检查，分析单次室性期前收缩后HRT的初始值（TurbulenceOnset，TO）和斜率（TurbulenceSlope，Ts）。结果对各组患者一般情况的比较分析表明，合并组与高血压组相比，早发冠心病家族史、空腹血糖水平、甘油三酯水平存在显著差异。高血压组、冠心病组、合并组的TO、TS值与正常对照组比较均有显著统计学差异（P〈0．01～0．05）；高血压组的TO、TS值与冠心病组和合并组比较亦有显著统计学差异（P〈0．01）。结论高血压、冠心病及高血压合并冠心病患者HRT指标明显异常，其中高血压合并冠心病患者HRT指标受损最严重。

Heart rate turbulence in patients with primary hypertension complicating premature coronary heart disease

Objective To investigate the characteristics of indexes of heart rate turbulence(HRT) in the patients with primary hypertension complicating premature coronary heart disease(CHD),and difference in HRT among the patients with simple hypertension and the patients with simple CHD.Methods The hospitalized patients(n=124) were divided into normal control group,hypertension group,CHD group and primary hypertension complicating premature CHD group(complicating group) according to their results of coronary angiography(CAG) exmination,laboratory tests and echocardiogram and the changes of blood pressure monitoring.All groups were given the examination of 24-hour dynamic ECG,and the values of turbulence onset(TO) and turbulence slope(TS) of HRT were analyzed after single ventrical extrasystole.Results The comparison and analysis of patients’ general conditions in all groups showed that there were significant differences in family history of premature CHD and levels of fasting plasma glucose(FPG) and triglyceride(TG) between complicating group and hypertension group.The difference in values of TO and TS was statistically significant in hypertension group,CHD group and complicating group compared with normal control group(P<0.05 to P<0.01),and also was statistically significant in hypertension group compared with CHD group and complicating group(P<0.01).Conclusion The index of HRT is obviously abnormal in the patients with hypertension,CHD or primary hypertension complicating premature CHD,which is the most serious in the patients with primary hypertension complicating premature CHD.