原发性高血压心率变异性-中医证候-炎症指标的关联网络分析OACSTPCD

Objective To explore the distribution of TCM syndromes,differences in inflammatory indicators,and their correlation in 158 hypertension patients with different heart rate variability(HRV).Methods From February 2019 to February 2021,158 patients with essential hypertension in the Department of Integrated Cardiology of China-Japan Friendship Hospital were selected.Statistical analyses were performed using SPSS 24.0.First,the differences in clinical characteristics between patients with different syndromes were compared.Second,according to the median standard deviation of the 24-hour normal RR interval(SDNN),the patients were divided into high-value HRV group and low-value HRV group(≤median SDNN value),and the differences between the two groups were compared.Further multivariate logistic regression analysis was carried out to identify the independent factors affecting HRV values,and finally,an ROC curve was drawn to evaluate the predictive efficiency.Results There were statistical differences in BMI,hypertension duration,IL-1β,IL-6,TNF-α,HDL-C,and HRV indices(SDNN,SDANN)among different syndromes(all P<0.05).There was a significant difference in the distribution of syndrome types between the high-value HRV group and the low-value HRV group(P<0.05).In the low-value HRV group,the distribution ratio of syndrome types was yin deficiency and yang hyperactivity syndrome>phlegm-dampness congestion syndrome>overabundant liver-fire syndrome>yin and yang deficiency syndrome.In the high-value HRV group,it was phlegm-dampness congestion syndrome>overabundant liver-fire syndrome>yin deficiency and yang hyperactivity syndrome>yin and yang deficiency syndrome.There were also differences in inflammatory indicators between the two groups,with IL-1β,IL-6,and TNF-α being higher in the low HRV group compared to the high HRV group(P<0.05).Multivariate logistic regression analysis showed that yin deficiency and yang hyperactivity syndrome(OR=2.503,95%CI 1.1025.684),gender(OR=4.690,95%CI 1.94011.338),age(OR=1.095,95%CI 1.0421.151),family history of hypertension(OR=2.967,95%CI 1.2187.226),and 24-hour mean diastolic blood pressure(OR=1.107,95%CI 1.051～1.167)were correlated with HRV in hypertensive patients(all P<0.05).ROC curve analysis showed that the area under the curve(AUC)of the total prediction model was the largest(AUC=0.827),and the AUCs of age,yin deficiency and yang hyperactivity syndrome,female,TNF-α,24-hour mean diastolic blood pressure,and family history of hypertension were 0.633,0.657,0.625,0.603,0.657,and 0.587,respectively.Conclusion TCM syndrome types,inflammatory indicators,and HRV in patients with essential hypertension are all correlated.Yin deficiency and yang hyperactivity syndrome interacts with TNF-α,and the combination of yin deficiency and yang hyperactivity syndrome with TNF-α can serve as predictors of lower HRV.