高血压伴左心室肥厚患者心率震荡的变化及临床意义

目的探讨心率震荡(HRT)在高血压左心室肥厚患者预后判断中的意义。方法对高血压伴左心室肥厚患者、高血压无左心室肥厚患者及健康对照者各45例进行24 h动态心电图检查,分别计算震荡初始(TO)及震荡斜率(TS),并比较3组受试者TO及TS均值,以及TO及TS异常的发生率。结果高血压伴左心室肥厚组与高血压无左心室肥厚组、健康对照组比较,TO增加,TS减低,TO及TS异常发生率明显升高,差异均有统计学意义(P<0.01);而高血压左心室肥厚组HRT异常亚组的复合心脏事件发生率明显高于HRT正常亚组(P<0.05)。结论高血压伴左心室肥厚患者心率震荡现象明显减弱,HRT可作为评价高血压左心室肥厚患者自主神经功能状态和发生心脏事件的独立预测因素。

Clinical significance of heart rate turbulence in patients with hypertension and left ventricular hypertrophy

Objective To discuss the clinical significance of heart rate turbulence（HRT） in prognosis of hypertension with left ventricular hypertrophy. Methods Three groups （45 cases in each group） were entolled the study,included hypertension with left ventricular hypertrophy, hypertension without left ventricular hypertrophy, and healtby volunteer. Twenty-four hour Holter monitoring was performed in all patients. The turbulence onset （TO） and turbulence slope（TS） were calculated from Hoher records. The mean values of TO and TS among 3 groups were com- pared, and the incidence of abnormal TO and TS were calculated. Results Compared hypertension with left veutricular hypertrophy group and without left ventricular hypertrophy group, control group, the Hoher record displayed that the TO was significant increased and the TS decreased,the incidence of abnormal TO and TS significantly higher（ P 〈 0.01 ）. The incidence of cardiac events in HRT abnormal subgroup was significantly higher than that in HRT normal subgroup （ P 〈 0.05 ）. Conclusion The HRT was significantly blunted in hypertension with left ventricular hypertrophy patients. Furthermore ,the HRT could be independent clinical predictor of automatic nervous system and cardiac events in hypertension with left ventricular hypertrophy patients.