原发性高血压患者动态血压与窦性心率震荡的关系

The Relationship between Ambulatory Blood Pressure and Heart Rate Turbulence in Essential Hypertension

目的探讨原发性高血压（EH）患者动态血压与窦性心率震荡（HRT）的关系。方法对100例EH患者进行24h无创性动态血压监测和24h动态心电图检查，分别计算平均收缩压（24hSBP）、平均舒张压（24hDBP）、昼夜节律、震荡初始（TO）及震荡斜率（Ts），根据动态血压结果将患者分为24hSBP、24hDBP1、2、3级组；昼夜节律正常组、昼夜节律消失组，并比较各组患者TO及Ts均值。结果TO值：24hSBP各组间TO值差异有统计学意义[（-2．30±2．15）vs（-1．55±1．29）vs（-1．07±1．02）％]，24hDBP各组闻TO值差异有统计学意义[（-2．28±2．03）vs（-1．65±1．18）vs（-1．14±0．93）％]，血压越高TO负值越低；昼夜节律正常组较昼夜节律消失组TO负值增高[（-1．89±1．05）vs（-0．45±0．29）％]，差异有统计学意义；TS值：24hSBP各组间TS值差异有统计学意义[（3．16±2．07）vs（2．43±1．68）vs（1．88±1．37）ms／RR]，24hDBP各组间差异有统计学意义[（3．26±2．12）vs（2．63±1．45）vs（1．78±1．39）ms／RR]，血压越高TS越低；昼夜节律正常组较昼夜节律消失组TS明显增大[（3．21±2．10）vs（2．33±1．88）ms／RR]，差异有统计学意义。结论原发性高血压患者HRT现象减弱或消失与其血压高低及昼夜节律有密切关系，提示血压越高者及昼夜节律消失患者自主神经功能明显受损。

Objective To study the relationship between ambulatory blood pressure and heart rate turbulence in essential hypertension. Methods A total of 100 patients with essential hypertension were examined using 24 hour Hoher and ambulatory blood pressure monitoring, to obtain the value of 24 h SBP, 24 h DBP, blood pressure circadian rhythm, Turbulence Onset （TO） and Turbulence Slope （TS）. Patients were divided into SBP 1 grade group, SBP 2 grade group, SBP 3 grade group, DBP 1 grade group, DBP 2 grade group, DBP 3 grade group, normal blood pressure circadian rhythm group and blood pressure circadian rhythm disappearing group. Values between these groups were compared. Results The value of TO between different 24h SBP groups were significantly difference[（ -2.30 ±2. 15）vs（ -1.55 ±1.29） vs（ -1.07 ± 1.02）% ] ,The value of TO between different 24 hDBP groups were significantly difference[ （ - 2.28 ± 2.03 ） vs （ - 1.65 ± 1.18 ） vs （ - 1.14 ± 0.93 ） % ], the more higher value of blood pressure, the more lower value of TO. Compared with blood pressure circadian rhythm disappearing group,TO in normal blood pressure circadian rhythm group was significantly lower[ （ - 1.89 ± 1.05 ） vs （ - 0.45 ± 0.29 ） % ]. The value of TS between different 24 h SBP groups were significantly different [ （3.16 ± 2.07） vs （ 2.43 ± 1.68 ） vs （ 1.88 ± 1.37 ）ms/RR]. The value of TS between different 24 h DBP groups were significantly different [ （3.26 ± 2.12 ） vs （2.63 ± 1.45 ） vs （ 1.78 ± 1.39 ） ms/RR ]. Compared with blood pressure circadian rhythm disappearing group, TS in normal blood pressure circadian rhythm group was significant higher[ （3.21 ± 2.10）vs （2.33 ± 1.88） ms/RR ]. Conclusion There is a correlation between the abated heart rate turbulence and the value of blood pressure and blood pressure circadian rhythm in patients with essential hypertension. The abated is associated with blood pressure and blood pressure circadian rhythm in hypertension patients. The function of autonomic nerve was hurt severely in patients with hypertension and blood pressure circadian rhythm disappearing.