原发性高血压患者静息心率与迷走神经的关系-东南大学学报医学版

原发性高血压患者静息心率与迷走神经的关系

单位：武汉市第一医院心电诊断科, 湖北武汉 430030

分类号：R540.4

出版年·卷·期（页码）：2017·36·第二期（257-260）

摘要：

目的：探讨原发性高血压患者静息心率（RHR）与迷走神经张力的关系。方法：404例原发性高血压患者根据GE MAC-800心电图机测定的静息心率分为三组。原发性高血压患者临床资料比较，分别计算迷走神经张力各项指标，比较各组间上述指标差异，并分析各指标与静息心率变化的关系。结果：随着静息心率升高，患者血压水平升高且组间差异显著（P<0.05）。静息心率升高显示HF和DC水平均有降低，组间变化明显（P<0.05）。除DR4与静息心率呈正相关（r=0.022，P=0.656），HF、DC、DR2及DR8均与静息心率呈负相关（r=-0.428，P=0.000；r=-0.216，P=0.000；r=-0.226，P=0.000；r=-0.040，P=0.422）。回归分析显示，HF、DC、DR4及DR8是静息心率变化的影响因素（P<0.05）。ROC曲线分析显示，HF、DC对高血压病具有较好的诊断意义，ROC曲线面积均大于0.8。结论：原发性高血压患者体内迷走神经张力变化引起静息心率升高，其中DRs的三个具有预警病死率能力的参数与静息心率升高有密切联系，静息心率升高可能作为解释原发性高血压患者的病死率的原因之一。

Objective: To investigate the relationship between resting heart rate(RHR) and vagal tone in patients with essential hypertension. Methods: 404 patients with essential hypertension were divided into three groups according to the resting heart rate detected by MAC-800 GE ECG machine. The clinical data of patients with essential hypertension were compared. The differences between the indexes of parameters of vagus nerve tension were compared, and the relationship between the indexes and resting heart rate was analyzed. Results: The blood pressure level of patients increased with the increase of resting heart rate. And the difference among the different groups was significant(P<0.05). With the increase of resting heart rate, the levels of HF and DC were decreased. And the difference among the three groups was significant(P<0.05). With the exception of DR4 positively correlated with resting heart rate(r=0.022, P=0.656), HF,DC,DR2 and DR8 were negatively correlated with resting heart rate(r=-0.428, P=0.000; r=-0.216, P=0.000; r=-0.226, P=0.000; r=-0.040, P=0.422,). Regression analysis showed that HF, DC, DR4 and DR8 were the influencing factors of resting heart rate(P<0.05). ROC curve analysis showed that HF and DC had good diagnostic significance for essential hypertension, and the area of ROC curve was more than 0.8. Conclusion: In patients with essential hypertension, the changes of vagal tone led to the increase of resting heart rate. Three early warning mortality DRs' parameters were associated with increasing resting heart rates, which may be one of the causes of mortality in patients with essential hypertension.

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