中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2014年
34期
29-32
,共4页
高血压%糖耐量减低%心率变异性
高血壓%糖耐量減低%心率變異性
고혈압%당내량감저%심솔변이성
Hypertension%Impaired glucose tolerance%Heart rate variability
目的 观察原发性高血压(EH)及EH合并糖耐量减低(IGT)患者心率变异性(HRV)的变化,探讨EH、EH合并IGT患者自主神经功能的改变.方法 从门诊体检人群中筛选病例166例,其中EH组62例,EH合并IGT组56例,健康对照组48例,测定HRV及相关生化指标.结果 EH组与健康对照组比较,R-R间期的标准差(SDNN)、5 min窦性R-R间期平均值的标准差(SDANN)、每5 min窦性R-R间期标准差的平方根(SDNNi)、窦性相邻R-R间期差值＞50 ms的心搏数占窦性总搏数的百分比(PNN50)均下降,C肽、高敏C反应蛋白(hs-CRP)升高,差异有统计学意义(P＜0.05).EH合并IGT组与健康对照组比较,SDNN、SDANN、SDNNi、相邻R-R间期之差的均方根(rMSSD)、PNN50均下降,C肽、胰岛素、hs-CRP升高,差异有统计学意义(P＜0.01).EH合并IGT组与EH组比较,rMSSD、PNN50下降明显,差异有统计学意义(P＜0.01);C肽、胰岛素、hs-CRP升高,差异有统计学意义(P＜ 0.05或＜0.01).结论 EH、EH合并IGT者HRV指标均下降,提示存在自主神经功能损害,且后者更严重,可能与胰岛素抵抗、hs-CRP升高相关.
目的 觀察原髮性高血壓(EH)及EH閤併糖耐量減低(IGT)患者心率變異性(HRV)的變化,探討EH、EH閤併IGT患者自主神經功能的改變.方法 從門診體檢人群中篩選病例166例,其中EH組62例,EH閤併IGT組56例,健康對照組48例,測定HRV及相關生化指標.結果 EH組與健康對照組比較,R-R間期的標準差(SDNN)、5 min竇性R-R間期平均值的標準差(SDANN)、每5 min竇性R-R間期標準差的平方根(SDNNi)、竇性相鄰R-R間期差值＞50 ms的心搏數佔竇性總搏數的百分比(PNN50)均下降,C肽、高敏C反應蛋白(hs-CRP)升高,差異有統計學意義(P＜0.05).EH閤併IGT組與健康對照組比較,SDNN、SDANN、SDNNi、相鄰R-R間期之差的均方根(rMSSD)、PNN50均下降,C肽、胰島素、hs-CRP升高,差異有統計學意義(P＜0.01).EH閤併IGT組與EH組比較,rMSSD、PNN50下降明顯,差異有統計學意義(P＜0.01);C肽、胰島素、hs-CRP升高,差異有統計學意義(P＜ 0.05或＜0.01).結論 EH、EH閤併IGT者HRV指標均下降,提示存在自主神經功能損害,且後者更嚴重,可能與胰島素牴抗、hs-CRP升高相關.
목적 관찰원발성고혈압(EH)급EH합병당내량감저(IGT)환자심솔변이성(HRV)적변화,탐토EH、EH합병IGT환자자주신경공능적개변.방법 종문진체검인군중사선병례166례,기중EH조62례,EH합병IGT조56례,건강대조조48례,측정HRV급상관생화지표.결과 EH조여건강대조조비교,R-R간기적표준차(SDNN)、5 min두성R-R간기평균치적표준차(SDANN)、매5 min두성R-R간기표준차적평방근(SDNNi)、두성상린R-R간기차치＞50 ms적심박수점두성총박수적백분비(PNN50)균하강,C태、고민C반응단백(hs-CRP)승고,차이유통계학의의(P＜0.05).EH합병IGT조여건강대조조비교,SDNN、SDANN、SDNNi、상린R-R간기지차적균방근(rMSSD)、PNN50균하강,C태、이도소、hs-CRP승고,차이유통계학의의(P＜0.01).EH합병IGT조여EH조비교,rMSSD、PNN50하강명현,차이유통계학의의(P＜0.01);C태、이도소、hs-CRP승고,차이유통계학의의(P＜ 0.05혹＜0.01).결론 EH、EH합병IGT자HRV지표균하강,제시존재자주신경공능손해,차후자경엄중,가능여이도소저항、hs-CRP승고상관.
Objective To observe the changes of heart rate variability (HRV) in patients with essential hypertension (EH) and EH associated with impaired glucose tolerance (IGT),and explore the change of autonomic nerve function in EH or EH associated with IGT patients.Methods A total of 166 individuals were enrolled from the physical examination center and divided into three groups,EH group (62 patients),EH associated with IGT group (56 patients) and control group(48 healthy individuals).HRV and its correlative biochemical indexes were detected.Results Compared with that in control group,the standard deviation of NN intervals (SDNN),standard deviation of average NN intervals in all 5 min segments of the entire recording (SDANN),standard deviation of average NN intervals in all 5 min segments of the entire recording index (SDANNi),the percentage of R-R intervals differing ＞ 50 ms (PNN50) decreased and C-peptide,high sensitivity C-reactive peptide (hs-CRP) level increased in EH group,and there was significant difference (P ＜ 0.05).Compared with that in control group,SDNN,SDANN,SDANNi,root mean square of successive differences (rMSSD),PNN50 decreased and C-peptide,insulin,hs-CRP level increased significantly in EH associated with IGT group,and there was significant difference (P ＜ 0.01).Compared with that in EH associated with IGT group,rMSSD,PNN50 decreased,C-peptide,insulin and hs-CRP level increased in EH group,and there was significant difference (P＜ 0.05 or ＜ 0.01).Conclusions HRV decreases in patients with EH and EH associated with IGT,reflecting the damage of autonomic function.Moreover,it suggests that the damage of autonomic function may associate with the increased insulin and hs-CRP.
