老年高血压患者静息心率与靶器官损害的研究-内科学专业论文.docxVIP

— — PAGE 1— 摘 要 老年高血压患者静息心率增加对靶器官损害的研究 研究生：韩永康 导师：张源明教授 摘 要 目的:探讨老年原发性高血压(EH)患者静息心率(RHR)与靶器官损害的关系。方 法:入选老年 EH 患者 619 例,按 RHR 水平分为 RHR1 组: 70 次/min(169 例),RHR2 组:70 次≤RHR80 次/min(251 例), RHR3 组:RHR≥80 次(199 例)三组。对所有入选患 者訽问病史及体格检查并行血脂、血糖检测行以及检查心电图、以下检查超声心动 图、颈动脉超声、肌酐清除率以及尿微量白蛋白及眼底动脉造影。结果:（1）三组患 者在年龄、病程方面无统计学意义（p＜0.05)。（2）RHR2 组和 RHR3 组的颈动脉内 膜厚度(IMT)、颈动脉内径(CAD)、左心室重量指数(LVMI)以及尿微量白蛋白定量 (MAU)均高于 RHR1 组(P0.01 或 p＜0.05),而左室射血分数(LVEF)、肌酐清除率小于 RHR1 组(P0.01 或 p＜0.05)，RHR2 及 RHR3 组较之 RHR1 组眼底动脉硬化程度重 (P0.01 或 p＜0.05)。结论:RHR 可能是老年 EH 患者靶器官损害的独立危险因素。 关键词：原发性高血压；静息心率；老年；靶器官损害。 新疆医科大学医学硕士学位论文 The relationship between resting heart rate and target organs damage in senile essential hypertension Postgraduate: Han Yongkang Supervisor: prof. Zhang Yuanming Abstrtract Objective: To investigate the relationship between resting heart rate (RHR)and target organs damage in senile essential hypertension. Methods: All 619 elderly essential hypertensive patients(age: 60-89 years) were divided into three groups according to the levels of RHR[RHR1 group: RHR70 beats/minute (bpm)(169 cases); RHR2 group: 70 bpm≤RHR80bpm (251 cases); RHR3 group: RHR≥80 bpm (199cases)]. Electrocardiography, Echocardiography,carotidultrasonography, creatinine clearance rate ( CCr) and quantitative test for 24 hours′urinarymicroalbuminuria (MAU) were fundus artery arteriography performed .Results: Compared with RHR1-RHR2 groups, the RHR3 group showed with lower levels of MAU and left ventricular ejection fraction(LVEF) (p0.01 或 p＜0.05). Compared with RHR1 and RHR2 groups, RHR3 group showed with higher levels of carotid intima-medial thickness (IMT) and carotid arterial diameter(CAD), lower CCr and MAU (p0.01 或 p＜0.05). The faster the heart rate,the more severe or ocular fundus arteriosclerosis.（p0.01 或 p＜0.05)．Conclusions: RHR is one of the important independent risk factors of TOD in senile essential hypertension. Key words: hypertension;heart rate;multiple organ failure;senil 中英文缩略词对照表 英文