失眠对老年高血压患者心率变异性的影响

Effects of insomnia on heart rate variability in the elderly with hypertension

目的探讨失眠对老年高血压患者心率变异性（HRV）的影响。方法入选老年患者259例，分为健康对照组74例、单纯高血压组71例、高血压并存失眠组114例，其中高血压并存失眠组按失眠病程分为〈5年、5～9年和≥10年。进行24h动态心电图检查，收集其HRV时域指标（SDNN、SDANN和ASDNN）进行对比分析。结果与健康对照组相比，单纯高血压组和高血压并存失眠组HRV各时域指标降低（F=12．02，10．54和4．27，P％0．01）；与单纯高血压组相比，高血压并存失眠组HRV各时域指标降低（P〈0．01）。高血压并存失眠组中失眠5～9年和≥10年组的SDNN和SDANN均较失眠〈5年降低（F=8．63和4．54，P〈0．01）；失眠≥10年的SDNN较5～9年进一步降低，差异具有统计学意义（P〈O．01）。结论失眠可加重高血压患者自主神经功能紊乱，失眠年限延长，高血压患者自主神经功能紊乱程度增加。

Objective To explore the effects of insomnia on heart rate variety（HRV） in aged hypertension patients. Methods 259 subjects were divided into healthy group （74 cases）, simple hypertension group （71 cases）, coexisting hypertension and insomnia group （114 cases） which was sub-grouped to 〈5 years, 5 9 years and ≥10 years according to the duration of insomnia. All subjects had 24 h recordings of ECG. The data of HRV time domain （SDNN, SDANN and ASDNN） were collected and compared. Results HRV time domain was lower in healthy group than in the other two groups （F=12,02, 10.54 and 4.27, P〈0. O1）, and decreased more significantly in coexisting hypertension and insomnia group compared with simple hypertension group（P〈0.01）. The values of SDNN and SDANN in 5 9 years and ≥10 years subgroups decreased as compared with 〈5 years subgroup （F=8.63 and 4.54, P〈0.01）, and these values further lower in ≥10 years subgroup than in 5-9 years subgroup （P〈0. 01）. Conclusions Insomnia may lead to more serious disorder of automatic nervous system and further aggravated disorders appear in the elderly with hypertension along with increasing years of insomnia.