“杓型”与“非杓型”高血压患者的静息-活动和睡眠-觉醒昼夜节律

The Relationship of Circadian Rhythms of Sleep-wake, Rest-activity to the circadian Blood Pressure profile

目的研究不同血压节律的高血压患者的静息活动、睡眠觉醒昼夜节律情况。方法对42例高血压患者和21例健康志愿者进行研究,所有受试者同时佩戴动态血压监测仪和静息活动监测仪进行动态血压和静息活动监测,动态血压监测24h,而静息活动监测48h。结果本次研究发现,非杓型高血压患者夜间活动水平(L5)显著增高(P<0·05),睡眠效益(SE)显著下降(P<0·05),夜间觉醒点数(WB)显著增多(P<0·05),睡眠觉醒破碎指数(FI)显著增高(P<0·05)。结论与杓型高血压患者相比,非杓型高血压患者的静息活动、睡眠觉醒昼夜节律发生了变化,即夜间活动增多,睡眠效益下降,夜间觉醒点数和睡眠节律破碎性增加,活动与睡眠可能是影响血压昼夜节律的两个重要因素。

Objective To investigate if the circadian rhythms of sleep-wake and rest-activity differ in dippers and nondippers types of the hypertension. Methods Forty-two hypertensive patients and twenty- one healthy volunteers were recruited. Ambulatory blood pressure monitor and a wrist actinograph were simultaneously used to record circadian sleep-wake and rest activity rhythms for two days. The blood pressure was measured every thirty minutes for twenty-four hours, Results We found that L5 （average level of 5 hour lowest activities during night）, WB（number of wake bouts） and FI （fragmentation index） were significantly increased in hypertensive nondippers, sleep quality was significantly decreased in these subjects. Conclusion The data derived from actigraph showed a significant alteration of circadian rhythms of sleep-wake and rest-activity regime in hypertensive nondippers.