The Correlation among Heart Rate Variability Blood Pressure and Urine Protein-to-Creatinine Ratio in Gestational Hypertension Complicated with Diabetes
WANG Xiaoning, WEI Xueyang, DU Xiaojie, et al
The No.987 Hospital of the Joint Service Support Force of the Chinese People's Liberation Army,Shaanxi Baoji 721004, China
摘要目的: 探究妊娠期高血压(Hypertensive Disorders of Pregnancy,HDP)合并糖尿病患者的心率变异性、血压水平与尿蛋白/肌酐比值的相关性。方法: 选取2022年6月至2024年6月本院收治的妊娠期高血压合并糖尿病患者106例为研究组,另选取同期本院妊娠期高血压患者106例为HDP组;及同期本院106例正常孕妇为对照组;比较三组患者的血压水平、心率变异性与尿蛋白/肌酐比值的差异,皮尔逊分析其相关性;ROC分析诊断的价值。结果: 研究组患者的24h舒张压(Diastolic Blood Pressure,DBP)、24h收缩压(Systolic Blood Pressure,SBP)、日间DBP与SBP、夜间DBP与SBP均高于HDP组、对照组,差异有统计学意义(P<0.05)。研究组患者的NN间期均值标准差(Standard Deviation of the Average of All Normal NN Intervals,SDANN)、NN间期差值个数百分比(Proportion of NN50 divided by total number of NNs,PNN50)、相邻NN间期差值均方根值(Root Mean Square of the Standard Deviation of All NN Intervals,RMSSD)、NN间期标准差(Standard Deviation of NN Intervals,SDNN)均低于HDP组与对照组,ACR高于HDP组与对照组;差异有统计学意义(P<0.05)。皮尔逊相关性显示ACR与24hDBP、24hSBP互呈正相关(r=0.755、0.724,P<0.05);24hDBP与PNN50互呈负相关(r=-0.259,P<0.05);24hSBP与SDANN、PNN50、RMSSD、SDNN互呈负相关(r=-0.213、-0.355、-0.194、-0.256,P<0.05)。ROC曲线分析显示,尿蛋白/肌酐比值、血压水平、心率变异性诊断妊娠期高血压合并糖尿病的AUC分别为0.885、0.991、0.931;敏感度分别为89.6%、99.1%、90.6%;特异性分别为70.8%、90.6%、88.7%。结论: 妊娠期高血压合并糖尿病患者的心率变异性降低与血压升高负相关,同时ACR与血压升高正相关;强调心率变异性、血压水平与ACR在评估病情及预测并发症中的重要性,为临床提供参考。
Abstract：Objective: To explore the correlation between heart rate variability,blood pressure levels,and urine protein/creatinine ratio in patients with gestational hypertension and diabetes mellitus. Methods: A total of 106 patients with gestational hypertension complicated by diabetes admitted to our hospital from June 2022 to June 2024 were selected as the study group.Additionally,106 patients with gestational hypertension admitted to our hospital during the same period were selected as the HDP group,and 106 normal pregnant women admitted to our hospital during the same period were selected as the control group.The differences in blood pressure levels,heart rate variability,and urine protein-to-creatinine ratio among the three groups were compared,and Pearson's correlation analysis was performed to assess their associations.ROC analysis was conducted to evaluate the diagnostic value. Results: The 24h DBP,24h SBP,daytime DBP and SBP,and nighttime DBP and SBP in the study group were higher than those in the HDP group and control group,with statistically significant differences (P<0.05).The SDANN,PNN50,RMSSD,and SDNN in the study group were lower than those in the HDP group and control group,while ACR was higher in the study group than in the HDP group and control group; the differences were statistically significant (P<0.05).Pearson's correlation analysis showed a positive correlation between ACR and 24hDBP,24hSBP (r=0.755,0.724,P<0.05); a negative correlation between 24hDBP and PNN50 (r=-0.259,P<0.05); and a negative correlation between 24hSBP and SDANN,PNN50,RMSSD,and SDNN (r=-0.213,-0.355,-0.194,-0.256,P<0.05).ROC analysis showed that the AUCs for diagnosing gestational hypertension and diabetes mellitus using urine protein/creatinine ratio,blood pressure levels,and heart rate variability were 0.885,0.991,and 0.931,respectively; the sensitivities were 89.6%,99.1%,and 90.6%,respectively; and the specificities were 70.8%,90.6%,and 88.7%,respectively. Conclusion: Patients with gestational hypertension and diabetes mellitus exhibit decreased heart rate variability,which is negatively correlated with increased blood pressure,while ACR is positively correlated with increased blood pressure.This study emphasizes the importance of heart rate variability,blood pressure levels,and ACR in assessing the condition and predicting complications,providing a reference for clinical practice.
王晓宁, 魏雪洋, 杜小洁, 李燕华, 耿俐. 妊娠期高血压合并糖尿病心率变异性血压与尿蛋白/肌酐比值的相关性[J]. 河北医学, 2025, 31(10): 1675-1680.
WANG Xiaoning, WEI Xueyang, DU Xiaojie, et al. The Correlation among Heart Rate Variability Blood Pressure and Urine Protein-to-Creatinine Ratio in Gestational Hypertension Complicated with Diabetes. HeBei Med, 2025, 31(10): 1675-1680.
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2025, Vol. 31 
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