原发性高血压左室肥厚与窦性心律震荡关系

摘要

Objective To investigate the clinical significance of heart rate turbulence ( HRT) in essential hypertension with left ventricular hypertrophy ( LVH). Methods A total of 143 essential hypertensive patients and 46 control persons received examinations by 24-hour Holter electrocardiogram and echocardiogram. Patients with essential hypertension were divided into LVH group and hypertension group by the results of LVMI. HRT and HRV parameters were observed. Results TO in LVH group was significantly lower than that in hypertension group and control group. TS in LVH group was significantly higher than that in hypertension group and control group. There was a significant association between TO, TS and LVMI. Conclusion There was autonomic nerve imbalance in essential hypertension. The impairment of sympathetic and parasympathetic function may be involved in pathogenesis of left ventricular remodeling. The degree of impairment seemed to be ongoing severe in the modeling process of left ventricular structure.%目的 探讨原发性高血压患者左室肥厚与窦性心率震荡(HRT)的关系.方法 143例原发性高血压患者根据超声心动图测定的左室重量指数( LVMI)分为左室肥厚组及单纯高血压组,46例同期体检健康者作为对照组.分别计算HRT和心率变异性(HRV)各项指标,比较各组间上述指标差异,并分析震荡初始(TO)、震荡斜率(TS)与LVMI之间的关系.结果 与对照组比较,左室肥厚组及单纯高血压组均显示TO升高、TS降低,左室肥厚组变化明显(P均＜0.05).TO与LVMI呈负相关(r=-0.387,P=0.015),TS与LVMI呈正相关(r=0.626,P=0.01).结论 原发性高血压患者体内自主神经功能失衡,交感与副交感神经的双重损害参与了高血压的左室重构机制,且其损害程度可能伴随左室重构过程而加重.