降压治疗对老年高血压及合并脑梗死患者心率变异性的影响

Effect of anti-hypertension therapy on heart rate variability in the senile hypertension patients and the patients with cerebral infarction

目的研究不同程度降压对老年高血压及合并腔隙性脑梗死患者心率变异性的影响,探讨高血压不同病理状态下HRV变化的差异。方法选择老年原发性高血压(高血压组)及合并腔隙性脑梗死(腔梗组)患者各33例为观察对象;同期健康老年人自愿者(健康对照组)27例,测定降压治疗前后不同血压水平下心率变异性参数的变化。结果降压治疗前高血压并脑梗组和高血压组心率变异性的各时域指标均较正常组明显减小,其中高血压并脑梗组较高血压组减小更明显,但2组比较仅SDNNI和RMSSD差异有统计学意义(P<0.05)。降压治疗后无论高血压组或高血压并脑梗组各时域指标均有不同程度的增高,第2次降压较第1次降压后各组各时域指标增高更明显。第1次降压后和降压前比较,各时域指标仅高血压组SDANNI和PNN50差异有统计学意义(P<0.05);第2次降压后和降压前比较,高血压组SDNN、SDANNI和PNN50差异有统计学意义(P<0.05),高血压并脑梗组SDNN和PNN50亦有显著差异;第2次降压后与第1次降压后比较,仅SDNN有显著差异(P<0.05)。结论高血压及合并腔隙性脑梗死患者心率变异性均有不同程度降低,合理降压治疗可部分提高不同病理阶段高血压患者心率变异性,改善自主神经功能。

Objective To detect the effect of anti-hypertension on the heart rate variability（HRV）of senile hypertension patients and the patients with cerebral infarction, and to investigate the difference of HRV in the hypertension patients at different pathological stages. Methods 33 senile primary hypertension patients with cerebral infarction were selected as cerebral infarction group, and 33 senile hypertension patients were selected as hypertension group. 27 healthy senile people were selected as control group during the same period. The heart rate variability parameters were measured between pre-and post-anti-hypertension in different levers of blood pressure. Results All period indicates of HRV in hypertension patients with cerebral infarction group and hypertension patients group were both significantly lower than control group before anti-hypertension, and hypertension patients with cerebral infarction group were markedly lower than hypertension patients group, but only SDNNI and RMSSD had statistic difference. All period indicates increased in hypertension patients group and hypertension patients with cerebral infarction group after anti-hypertension therapy, the second anti-hypertension were markedly higher than the first anti-hypertension. The first post-anti-hypertension compared with the pre-hypertension, SDANNI and PNN50 had statistic difference in hypertension patients group; the second post-anti- hypertension compared with the pre-anti-hypertension： SDNN, SDANNI and PNN50 had statistic difference in hypertension patients group, SDNN and PNN50 also had statistic difference in hypertension patients with cerebral infarction group; the second post-anti-hypertension compared with the first post-anti-hypertension, only SDNN had statistic difference in both groups. Conclusion HRV decreased in hypertension patients and the patients with cerebral infarction, anti-hypertension can partly improve HRV in hypertension patients at different pathological stages, and improve autonomic nervous function.