| 焦虑对中青年高血压患者心率变异性的影响 |
| 投稿时间：2025-05-06 修订日期：2025-07-01 点此下载全文 |
| 引用本文：卢彦娜,郭海英,珠娜,原 1 满姗姗,田巍.焦虑对中青年高血压患者心率变异性的影响[J].医学研究杂志,2025,54(11):78-81, 115 |
| DOI：
10.11969/j.issn.1673-548X.2025.11.015 |
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| 基金项目:首都卫生发展科研专项项目(首发2024-2Y-014) |
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| 中文摘要:目的 探讨中青年高血压患者焦虑的危险因素及焦虑对心率变异性(heart rate variability, HRV)的影响。方法 采用回顾性病例对照研究方法,选取2017年1月~2019年12月首都医科大学附属北京积水潭医院收治的110例中青年高血压合并焦虑患者作为病例组,另选取同期住院的年龄、性别、婚姻、体重指数(body mass index, BMI)相匹配且不合并焦虑的110例中青年高血压患者作为对照组。收集并比较两组患者的年龄、性别、BMI、婚姻状态等一般资料及24h动态心电图结果。采用多因素Logistic回归分析评估中青年高血压患者焦虑的危险因素；采用Pearson相关性分析评估焦虑自评量表(self-rating anxiety scale, SAS)评分与HRV各指标之间的相关性。结果 多因素Logistic回归分析结果显示,合并慢性疾病数量、睡眠质量欠佳、不规律用药、高高血压分级是中青年高血压患者出现焦虑的独立危险因素(P＜0.05)。病例组患者的时域指标包括24h内全部正常心动周期的标准差(the standard deviation of NN intervals, SDNN)、相邻正常心动周期差值的均方根(root mean square successive differences, rMSSD)、差值>50ms的两相邻正常周期个数占比(percentage of RR interval that differ by 50ms, PNN50),以及频域指标包括高频带面积(high frequency power, HF)、低频带面积(low frequency power, LF)、极低频带面积(very low frequency power, VLF)、低频带面积与高频带面积比值(low frequency-to-high frequency power ratio, LF/HF)均明显低于对照组,差异均有统计学意义(P＜0.05)。HRV指标SDNN、rMSSD、PNN50、LF、HF、VLF、LF/HF与SAS评分呈负相关(P<0.05)。结论 合并慢性疾病数量、睡眠质量欠佳、不规律用药、高高血压分级是中青年高血压患者出现焦虑的独立危险因素,中青年高血压合并焦虑患者的HRV显著降低,SDNN、rMSSD、PNN50、LF等HRV指标与SAS评分呈负相关。因此,临床上应积极关注并干预中青年高血压合并焦虑患者。 |
| 中文关键词:中青年 高血压 焦虑 心率变异性 |
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| Effect of Anxiety on Heart Rate Variability in Young and Middle-aged Patients with Hypertension. |
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| Abstract:Objective To investigate the risk factors of anxiety and the effect of anxiety on heart rate variability (HRV) in young and middle-aged hypertensive patients. Methods A retrospective case-control study was conducted. A total of 110 young and middle-aged hypertensive patients with anxiety admitted to Beijing Jishuitan Hospital, Capital Medical University from January 2017 to December 2019 were selected as the case group, Another 110 young and middle-aged hypertensive patients without anxiety who were hospitalized during the same period, with matched age, gender, marital status, and body mass index (BMI) were selected as the control group. General data such as age, gender, BMI, marital status and 24-hour dynamic electrocardiography results were collected and compared between the two groups. Multivariate Logistic regression analysis was used to evaluate the risk factors of anxiety in young and middle-aged hypertension patients. Pearson correlation analysis was used to evaluate the correlation between Self-Rating Anxiety Scale (SAS) scores and HRV parameters. Results The results of multivariate Logistic regression analysis showed that the number of combined chronic diseases, poor sleep quality, irregular medication and high hypertension classification were independent risk factors for anxiety in young and middle-aged hypertensive patients. In the case group, the time domain indicators included the standard deviation of NN intervals (SDNN), root mean square successive differences (rMSSD), percentage of RR interval that differ by 50ms (PNN50), and the frequency domain indicators included high frequency power (HF), low frequency power (LF), very low frequency power (VLF), low frequency-to-high frequency power ratio (LF/HF) were significantly lower than those in the control group, and the differences were statistically significant (P<0.05). HRV indicators such as SDNN, rMSSD, PNN50, LF, HF, VLF and LF/HF were negatively correlated with SAS score (P<0.05). Conclusion The number of combined chronic diseases, poor sleep quality, irregular medication and high hypertension classification were the independent risk factors for anxiety in young and middle-aged hypertensive patients. The HRV of young and middle-aged hypertension patients with anxiety is significantly decreased, and HRV indicators such as SDNN, rMSSD, PNN50 and LF are negatively correlated with SAS score. Therefore, in clinical practice, active attention should be paid to and intervention should be carried out for young and middle-aged hypertension patients with anxiety. |
| keywords:Young and middle-aged Hypertension Anxiety Heart rate variability |
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