CAJ | 학술논문

目的探讨高血压并发冠心病患者的心率变异性和心律失常的特点.方法对50例原发性高血压(EH)患者、44例冠心病(CHD)患者和52例EH并发CHD患者与35例健康老年人的心率变异性(HRV)进行对比研究.结果 EH组和CHD组与对照组HRV时域法所有参数差异均有统计学意义(P＜0.05);EH并发CHD组与对照组比较,各参数差异均有统计学意义(P＜0.01);但不同疾病组间比较,差异均无统计学意义(P＞0.05).三个疾病组与对照组比较,房性期前收缩、房性心动过速和室性期前收缩的发生率差异均有统计学意义(P＜0.01);而EH组、CHD组及EH+CHD组间,除外CHD组与EH+CHD组房性期前收缩的发生率差异有统计学意义(P＜0.05)外,其余差异均无统计学意义.结论高血压患者和冠心病患者的自主神经功能受损,心律失常发生率增加(以房性期前收缩最常见,其次为室性期前收缩);当高血压患者并发冠心病时这种受损更加明显,其迷走神经张力降低,交感神经紧张性相对增高是导致老年患者心率变异性降低的主要原因和心律失常的可能因素.
목적 탐토고혈압병발관심병환자적심솔변이성화심률실상적특점.방법 대50례원발성고혈압(EH)환자、44례관심병(CHD)환자화52례EH병발CHD환자여35례건강노년인적심솔변이성(HRV)진행대비연구.결과 EH조화CHD조여대조조HRV시역법소유삼수차이균유통계학의의(P＜0.05);EH병발CHD조여대조조비교,각삼수차이균유통계학의의(P＜0.01);단불동질병조간비교,차이균무통계학의의(P＞0.05).삼개질병조여대조조비교,방성기전수축、방성심동과속화실성기전수축적발생솔차이균유통계학의의(P＜0.01);이EH조、CHD조급EH+CHD조간,제외CHD조여EH+CHD조방성기전수축적발생솔차이유통계학의의(P＜0.05)외,기여차이균무통계학의의.결론 고혈압환자화관심병환자적자주신경공능수손,심률실상발생솔증가(이방성기전수축최상견,기차위실성기전수축);당고혈압환자병발관심병시저충수손경가명현,기미주신경장력강저,교감신경긴장성상대증고시도치노년환자심솔변이성강저적주요원인화심률실상적가능인소.
Objective To study autonomic nerve regulator character and arrhythmias in the patients with essential hypertension(EH) and coronary heart disease(CHD). Methods The heart rate variability(HRV) and arrhythmias in 50 EH, 44 CHD, 52 EH + CHD patients and 35 healeh elderly subjects were investigated. Results There were significant differences of HRV in the patients with EH, CHD and healthy elderly subjects(P＜0.05).There was much significant difference of HRV between the patients with EH + CHD and healthy elderly subjects(P＜0.01), but no significant difference of HRV between the patients with EH and CHD(P＞0.05). The incidence rate of the premature atrial contraction, premature ventriculax contraction and atrial tachycardia in EH, CHD, EH+CHD and healthy elderly subjects, there were much significant differences( P＜0.01 ). Except the incidence rate of premature atrial contraction there was significant difference between the patients in CHD and EH + CHD (P＜0.05) ,and no significant differences of the incidence rate of other kinds of arrhythmias in the patients with EH,CHD and EH + CHD(P＞0.05 ). Conclusion The autonomic never function of EH and CHD patients was damaged, and the incidence rate of arrhythmias was increased(the premature atrial contraction often happened, then the premature ventricular contraction), and arrhymias happened in EH + CHD patients is most oftenly. The vagal hypoacfivity and sympathetic hyperactivity were major causes of reduction of HRV and probable causes in the elderly patients.