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目的 探讨并发不同常见慢性疾病的老年体位性低血压患者心率变异性（HRV）的特点。方法 将完善24小时动态心电图检查的267名60岁以上老年人分为体位性低血压组(OH组)和非体位性低血压组(非OH组)，对两组患者HRV的时域和频域分别进行比较；同时，对这两组患者中并发不同的单一疾病患者的HRV指标分别进行分析比较。结果 在非OH组，从时域性指标来看，高血压病最高，冠心病次之，糖尿病最低；从频域性指标来看，高血压病最高，糖尿病次之，冠心病最低。在OH组，从时域性指标来看，也是高血压病最高，冠心病次之，糖尿病最低；从频域性指标高频(HF)来看，也是高血压病最高，糖尿病次之，冠心病最低，但从低频(LF)来看，高血压病最高，冠心病和糖尿病差异不显著。与非OH组同病名同指标比较，OH组并发糖尿病的患者，时域性指标下降最为显著；OH组3种常见慢性病的频域性指标下降均很显著(P<0.05,P<0.01)。结论 老年体位性低血压患者中，并发糖尿病患者时域性指标下降显著，并发冠心病患者频域性指标下降显著。
Objective To investigate the characteristics of heart rate variability (HRV) in elderly patients with orthostatic hypotension complicated by different common chronic diseases. Methods A total of 267 elderly people over the age of 60 who underwent 24-hour ambulatory electrocardiography were divided into orthostatic hypotension group (OH group) and non-orthostatic hypotensive group (non-OH group). HRV time-domain and frequency Domain were compared; the same time, the two groups of patients complicated by different single disease in patients with HRV were analyzed and compared. The results in the non-OH group, from the time domain point of view, the highest hypertension, coronary heart disease followed by diabetes the lowest; from the frequency domain indicators, the highest hypertension, followed by diabetes, coronary heart disease lowest. OH group, from the time domain index, hypertension is the highest, followed by coronary heart disease, diabetes mellitus; from the high frequency of regional indicators (HF) point of view, is the highest hypertension, followed by diabetes, the crown Heart disease lowest, but from the low frequency (LF) point of view, the highest hypertension, coronary heart disease and diabetes were not significantly different. Compared with the same disease name and non-OH group indicators, OH group patients with diabetes mellitus showed the most significant decrease in the time domain index; the frequency of the three common chronic diseases in OH group decreased significantly (P & lt; 0.05, P & lt; 0.01). Conclusions Among the elderly patients with orthostatic hypotension, the time domain index of patients with diabetes mellitus decreased significantly, and the frequency domain indexes of patients with coronary heart disease decreased significantly.