苯那普利对原发性高血压患者心率变异性的影响

Effects of Benazepril on Heart Rate Variability of Essential Hypertensive Patients

目的：探讨苯那普利对原发性高血压患者心率变异性的影响。 方法：对４７例健康查体者行２４小时动态心电图作为正常对照组，比较８７例原发性高血压组患者服苯那普利前后做２４小时动态心电图，分析心率功率谱时域和频域指标。 结果：原发性高血压组用药前和用药后时域相邻正常ＲＲ间期标准差（ＳＤＮＮ）、ＲＲ间期平均值的标准差（ＳＤＡＮＮ）、高频功率和总功率、低频功率、低频功率／高频功率值分别显著低于和高于正常对照组，以上指标在原发性高血压组用药前后亦呈显著性变化。Ⅲ期原发性高血压患者的ＳＤＮＮ，高频功率和低频功率及低频功率／高频功率值与Ⅱ期原发性高血压患者比较Ｐ＜０．０５，显示植物神经功能损害与病情呈正比。各期原发性高血压患者经苯那普利治疗后心率变异损害均有改善和血压有效下降。正常对照组及原发性高血压组间其年龄、性别、心率、ＲＲ间期标准差的平均值、相邻正常ＲＲ间期差值的标准差、相邻正常ＲＲ同期差值大于 ５０ ｍｓ的窦性心律占心搏总数的百分比、极低频功率均无显著性差异。 结论：苯那普利在降压的同时，可改善原发性高血压患者的心率变异性。

Objective:To study the effect of Benazepril on heart rate variability of essential hypertensive patients. Methods:The heart rate power spectral density and time-domain was analyzed in 47 healthy subjects and in 87 pa- tients with hypertension before and after using the benazepril with 24 hour electrocardiographic recordings. Results:The low frequency and total frequency and ratio between low frequency and high frequency of hypertensive patients were significantly higher than that of control,the high frequency and standard deviation of normal-to-normal in- tervals (SDNN) and standard deviation of the mean of RR intervals for each 5 min period of the 24 hour electrocar- diographic recordings (SDANN) were significantly lower than that of control. The SDNN and high frequency of Ⅲ grade hypertension were significantly lower than that of Ⅱ grade hypertension. The low frequency and ratio between low fre- quency and high frequency of Ⅲ grade hypertension were significantly higher than that of Ⅱ grade hypertension. It shows that vegetative nerve functional damage has the positive relativity with hypertensive grade. The severer is the ill- ness, the greater is the change. After treatment of benazepril, in addition to lowing the blood pressure, the SDNN. SDANN and high frequency of hypertensive patients were significantly increased. The low frequency and total frequency and ratio between low frequency and high frequency of hypertensive patients were significantly decreased. Conclusion:When benazepril lowers blood pressure,it can improve significantly the heart rate variability of essential hypertensive patients.