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目的通过对比正常人的心率减速力(deceleration capacity of rate,简称DC),探讨高血压患者心率减速力(DC)在临床中的指导意义。方法随机选取2012年12月~2015年12月到我院就诊、体检以及住院的60例高血压患者,作为研究组;同时随机选取同期来我院进行体检的健康者60例作为对照组,采取离线分析心电图计算并对比两组的心率减速力(DC)值并分类;然后对两组患者均行24h动态心电图与血压监测,分析比较两组患者的DRs、HRV时域各值并进行猝死风险判定分层。结果 1研究组有9例低位者,51例中高危者,平均心率减速力(DC)为4.03±1.98ms,对照组51例低位者,8例中危,仅1例高危,平均心率减速力(DC)为7.71±4.80ms,两组对比差异具有统计学意义(P<0.05)。2研究组患者的SDNN、rMSSD、pNN50、DR4与DR8等均显著低于对照组,两组对比差异具有统计学意义(P<0.05);两组的DR2值对比无明显差异。结论心率减速力(DC)与HRV时域有一定的相关性,均可以作为自主神经功能的检查标准之一,能够有效地对中高危高血压患者进行筛查及预警。
Objective To compare the normal rate of deceleration (deceleration capacity of rate, referred to as DC) to investigate the clinical significance of heart rate deceleration (DC) in hypertensive patients. Methods Sixty hypertensive patients were randomly selected from December 2012 to December 2015 in our hospital for medical examination, hospitalization and hospitalization, and were selected as the research group. At the same time, 60 healthy people who were in our hospital during the same period were randomly selected as the control group, The electrocardiogram (ECG) was analyzed offline and the DC decelerations (DCs) of the two groups were compared and classified. Then, the dynamic electrocardiogram and blood pressure were monitored 24h. The values of DRs and HRV in both groups were compared and risk of sudden death Determine the stratification. Results In the study group, there were 9 low-lying persons and 51 middle-high-risk women with an average heart rate deceleration (DC) of 4.03 ± 1.98 ms. In the control group, 51 patients were low and 8 were moderate-risk patients. Only 1 high risk and average heart rate deceleration (DC) was 7.71 ± 4.80ms, the difference between the two groups was statistically significant (P <0.05). The SDNN, rMSSD, pNN50, DR4 and DR8 in the study group were significantly lower than those in the control group, with significant difference between the two groups (P <0.05). There was no significant difference in DR2 between the two groups. Conclusions There is a certain correlation between heart rate deceleration (DC) and HRV time domain, which can be used as one of the inspection criteria of autonomic nervous function, which can effectively screen and early warning of hypertension in middle and high risk patients.