原发性高血压病人血压昼夜节律变化与心率变异的相关分析

Relation between Circadin Rhythm of Blood Pressure and Heart Rate Variability in Essential Hypertension

为探讨原发性高血压患者的血压昼夜节律的变化与心率变异的关系，对６５例原发性高血压患者进行了２４ｈ动态血压监测，用时域分析法对心率变异性（ＨＲＶ）各项指标进行了检测，并与３８例正常对照比较。结果：代表心率总变异程度的ＳＤＮＮ（２４ｈ正常ＲＲ间期标准差），ＳＤＡＮＮＩ（２４ｈ５ｍｉｎ平均ＲＲ间期标准差）明显下降（Ｐ＜０．０５）。按照夜间血压下降百分率将原发性高血压病人分为节律消失组、节律正常组，并分别与正常对照组比较，发现节律消失组ＨＲＶ各项指标下降更为显著，ＳＤＮＮ、ＳＤＡＮＮＩ、ＳＤＮＮＩ（２４ｈ５ｍｉｎ正常ＲＲ间期标准差均值）不但显著低于正常对照组（Ｐ＜０．０５），也显著低于节律正常组（Ｐ＜０．０５）。说明在原发性高血压患者中，节律消失者的心脏自主神经系统功能损害更为严重。

To investigate the relationship between the circadin rhythm of blood pressure and the heart rate variability in essential hypertension, 65 cases of hypertensive disease were studied by means of mearsu ring the 24 h ambulatory blood pressure and the heart rate variability. The results showed that the patients with hypertension had lower SDNN and SDANNI as compared with the normal controls ( n = 38, P <0.05) and these changes had more significance (SDNN, SDANNI and SDNNI P <0.05) in the patients without circadin changes of blood pressure than those with such changes. These results show that cardiac autonomotropic function was impaired more in the former than in the later patients.