| Objectives To analyse the possible risk factors in the senile CHD of abnormal HRV.Investigate the effection of the common complications of hypertension and T2 DM on cardiac autonomic nerve that in senile patients with CHD in hospital.Methods Collected 365 cases of hospitalized senile patients with CHD, and in accordance with the inclusion criteria for 143 cases. Case inclusion criteria:(1) age 60 or higher;(2) conforms to the diagnosis and treatment guidelines of CHD set by the Chinese medical association in 2007. All the cases were collected of the basic data such as name,sex, age, smoking history, drinking history, body mass index, systolic blood pressure,diastolic blood pressure, the course of coronary heart disease, complication and the course of disease(hypertension, diabetes, etc), oral drug situation(mainly the situation of taking β-R blockers) and so on.At the same time, the routine test results were collected,including lipid series, fasting blood glucose, the QTc interval from standard 12 lead electrocardiogram, the heart rate variability analysis results from dynamic electrocardiogram(including SDNN, SDANN index, SDNN index, RMSSD and p NN50,HRV triangular index), nocturnal mean heart rate and the results of cardiac ultrasound.According to the HRV the cases can be divided into normal HRV group(n=91,SDNN ≥ 102ms)and abnormal HRV group(n=52,SDNN < 102ms).Then applied multivariate logistic regression analysis to analyse the possible risk factors in the senile CHD patients of abnormal HRV. According to the complication they can be divided into CHD of unincorporated hypertension and T2 DM group(T0,n=31),combined with hypertension group(T1,n=48), combined with T2 DM group(T2,n=30)and combined with hypertension and T2 DM group(T3,n=34).Compared among the four groups of patients with HRV indexes, QTc period, then to evaluate the changes of cardiac autonomic nerve. All data was inputted into SPSS20.0 software for statistical analysis.Count data was expressed by the number or percentage.Measurement data was demonstrated by(mean±SD). Two groups of measurement data were compared according to the results of normality and homogeneity of variance test. The t test was used for normal distribution data. Non-normal or grade data was analysis by the chi-square test or rank sum test. Multivariate logistic regression analysis was used to screen risk factors of senile CHD with abnormal HRV. Multiple comparison between groups using ANOVA test in the single factor analysis of variance. A values of P<0. 05 was considered as statistical significant.Results(1) The results of the study to screening risk factors grouped on the basis of HRV. 1. The course of CHD, hypertension, diabetes and LA in the comparison of the two groups were statistical differences(P<0.05). 2. Multivariate Logistic regression analysis showed that hypertension, diabetes and left atrial enlargement were major risk factors which result in the decrease of HRV in the senile patients with CHD(P<0.05).(2)The analysis results of the influence of hypertension and type 2 diabetes on the HRV. The parameters of SDNN, SDANN index, SDNN index, r MSSD, PNN50 and HRV triangular index in the T3 group were significantly lower than those in the other three groups(P<0.05). The average heart rate at night and the time of QTc in the T3 group were significantly elevated than those in the other three groups(P<0.05).Conclusions Hypertension, type 2 diabetes and left atrial enlargement were major risk factors which result in the damage of cardiac autonomic nervous system function in the senile patients with CHD. The autonomic nervous function of the heart was severely damaged in senile patients with CHD which combined with the complications of hypertension and type 2 diabetes. |
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