心率变异性与高血压病血压曲线变化的关系

Relationship of heart rate variability and changes of blood pressure curve in hypertension patients

目的探讨高血压患者血压曲线变化与自主神经昼夜活动的关系。方法将90例高血压患者根据动态血压监测结果分为杓型组(n=42)和非杓型组(n=48),以频域心率变异性(HRV)指标为参数,对两组的昼夜HRV指标(包括总频带,高频带,低频带,低频带/高频带,标准化高频带及标准化低频带)进行对比研究。结果杓型组白天舒张压及平均压水平均高于非杓型组(分别P<0.05或<0.01);非杓型组夜间收缩压及平均压水平明显高于杓型组(P<0.01)。白天杓型组低频带(LF),高频带(HF)较非杓型组升高(P<0.05);夜间杓型组标准化高频带(HFnu)较非杓型组升高;杓型组夜间LF/HF显著低于日间(P<0.01)。结论高血压曲线非杓型组患者的心血管自主神经功能损害较杓型组患者严重,而夜间以迷走神经受损为主,其血压昼夜趋于平衡,杓型曲线消失。

Objective To investigate the relationship between blood pressure curve and circadian rhythm of cardiac autonomic nervous system in hypertension patients. Methods Ninety hypertension patients were divided into two groups based on different blood pressure curve shape：dipping group（n=42）and non-dipping group（n=48）.HRV parameters were compared between two groups. Results The diastolic blood pressure and mean blood pressure at daytime in dipping group were higher than that in non-dipping group.The systolic blood pressure and mean blood pressure at nighttime in non-dipping group were higher than that in dipping group.Low frequency（LF）and high frequency（HF）at daytime in dipping group were higher than that in non-dipping group（P〈0.05）.At night normalized high frequency（HFnu）in dipping group significantly increased compared with non-dipping group.In dipping group,LF/HF was much lower at night than that at daytime. Conclusion In hypertension patients with non-dipping curve,the autonomic nerve dysfunction is more serious than that in patients with dipping curve,and the vagal dysfunction is dominant at night.In these patients,the blood pressure tends to be invarible during day and night and dipping shape disappears.