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目的探讨老年高血压患者静息心率(RHR)与靶器官损害的关系及其临床意义。方法150例老年高血压患者,按RHR水平分为<65次/min组(A组),52例;≥65~<80次/min组(B组),51例;≥80次/min组(C组),47例。对入选患者分别行超声心动图、颈动脉超声及头颅CT或MRI检查,测定RHR、血压、血糖、血脂、体质指数、肌酐、尿素氮、尿酸,进行分组研究。结果随着RHR水平的增加,收缩压、舒张压、脉压、体质指数、总胆固醇、低密度脂蛋白胆固醇、空腹血糖、尿酸有上升趋势;颈动脉内膜厚度、左室肥厚病例数增加;左室重量指数、临床神经功能缺损程度升高,左室射血分数、日常生活能力下降。各组间比较差异有统计学意义(P<0.05或P<0.01)。结论老年高血压患者随RHR的增高,发生心脑血管损害的机会也在增加,RHR可能是心脑血管疾病发生的危险因素及预后的预测因子。
Objective To investigate the relationship between resting heart rate (RHR) and target organ damage in elderly patients with hypertension and its clinical significance. Methods A total of 150 elderly hypertensive patients were divided into group A (n = 65), group A (n = 52), group B (n = 65 to 80) (Group C), 47 cases. The selected patients underwent echocardiography, carotid artery ultrasound and head CT or MRI examination, determination of RHR, blood pressure, blood glucose, blood lipids, body mass index, creatinine, urea nitrogen, uric acid, were grouped. Results The systolic blood pressure, diastolic blood pressure, pulse pressure, body mass index, total cholesterol, low density lipoprotein cholesterol, fasting blood glucose and uric acid increased with the increase of RHR. Carotid artery intima thickness and left ventricular hypertrophy increased. Left ventricular mass index, clinical neurological deficit increased, left ventricular ejection fraction, daily living ability decreased. The differences between the groups were statistically significant (P <0.05 or P <0.01). Conclusions With the increase of RHR in elderly hypertensive patients, the chances of developing cardiovascular and cerebrovascular injuries are also increasing. RHR may be the risk factor of cardiovascular and cerebrovascular diseases and the predictor of prognosis.