贵州医科大学学报

2016, v.41;No.195(12) 1485-1488

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血清同型半胱氨酸、踝臂指数和心率变异性与高血压前期的关系
Correlation between Serum Homocysteine,Ankle-Brachial Index,Heart Rrate Variability and Prehypertension

严姝瑛;朱兵;张小方;周霞;李洺;莫冬兰;
YAN Shuying;ZHU Bing;ZHANG Xiaofang;ZHOU Xia;LI Ming;MO Donglan;Shanghai Jiangong Hospital;

摘要(Abstract):

目的:探讨血清同型半胱氨酸(Hcy)、踝臂指数(ABI)和心率变异性(HRV)与高血压前期(PTH)的关系。方法:265例体检人群,根据血压水平分为理想血压组(141例)和PTH组(124例);采取Hcy酶循环法,检测血浆Hcy;检测踝部收缩压及肱动脉收缩压,计算ABI;24 h动态心电图检测HRV指标,包括窦性R-R间期标准差(SDNN)、窦性R-R间期标准差的均值(SDNN DX)、窦性R-R间期均值的标准差(SDANN)、相邻窦性RR间期差值的均方根(rM SSD)和相邻窦性R-R间期差值超过50 ms的个数占总窦性心搏个数的百分比(PNN50)。结果:PTH组的Hcy和ABI高于理想血压组,差异有统计学意义(P<0.05);PTH组SDNN、SDNN DX、SDANN、rM SSD及PNN50低于理想血压组,差异均有统计学意义(P<0.05);Logistic回归分析表明,BMI、Hcy和ABI是理想血压进展为PTH的独立危险因素。结论:Hcy、ABI和HRV均与PTH有关,将3者联合能更好评估高血压的危险程度。
Objective:To discuss the relationship between serum homocysteine(Hcy),ankle-brachial index(ABI),heart rate variability(HRV) and prehypertension(PTH).Method:265 cases of physical examination people,according to blood pressure level,were divided into the ideal blood pressure group(141 cases) and PTH group(124 cases).Hcy enzyme circulation method was adopted to detect plasma Hcy.ABI was calculated by detecting ankle systolic blood pressure and brachial artery systolic pressure.HRV index was detected by 24 h dynamic electrocardiogram,including sinus R-R interval standard deviation(SDNN),the mean sinus R-R interval standard deviation(SDNN DX),sinus R-R interval mean standard deviation(SDANN),the root mean square of adjacent sinus R-R interval difference(rM SSD) and the percentage of the number of adjacent sinus R-R interval difference of more than 50 ms in total number of sinus beats(PNN50).Results:The Hcy and ABI of PTH group were higher than their counterparts of the ideal blood pressure group,and the difference was statistically significant(P<0.05).The SDNN,SDNN DX,SDANN,rM SSD and PNN50 in PTH group lower than their counterparts of ideal blood pressure group,and the difference was statistically significant(P<0.05).Logistic regression analysis showed that BMI,Hcy,and ABI were independent risk factors for progression of the ideal blood pressure to PTH.Conclusion:Hcy,ABI and HRV are all related to PTH,and the combination of them can better assess the risk of hypertension.

关键词(KeyWords): 高血压;半胱氨酸;踝;心率;变异性
prehypertension;homocysteine;ankle-brachial index;heart rate;variability

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作者(Author): 严姝瑛;朱兵;张小方;周霞;李洺;莫冬兰;
YAN Shuying;ZHU Bing;ZHANG Xiaofang;ZHOU Xia;LI Ming;MO Donglan;Shanghai Jiangong Hospital;

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DOI: 10.19367/j.cnki.1000-2707.2016.12.028

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