高血压患者血压、心率变异性与颈动脉内中膜厚度的关系

RELATIONSHIPS OF BLOOD PRESSURE VARIABILITY,HEART RATE VARIABILITY AND CAROTID INTIMA-MEDIA THICKNESS IN PATIENTS WITH HYPERTENSION

目的探讨高血压患者血压、心率变异性与颈动脉内中膜厚度之间的关系。方法选择高血压患者86例及健康人42例进行动态血压、动态心电图监测及颈动脉内中膜厚度测量。结果 2个高血压组与对照组比较,其不同时段平均收缩压、24h收缩压标准差及日间收缩压标准差差异均有统计学意义;同时颈动脉内中膜增厚组(intima-media thickness,IMT)不同时段平均收缩压、24h收缩压标准差及日间收缩压标准差显著高于单纯高血压组(pure hypertension group,PHt)及对照组。2个高血压组与对照组比较,心率变异性降低;IMT组全部正常性R-R间期的标准差(standard deviation of the normal-to-normal interal,SDNN)减低程度明显高于PHt组及对照组。IMT组血压、心率变异性主要指标相关分析发现,24h收缩压标准差、日间收缩压标准差与SDNN呈负相关,而与低频功率/高频功率呈正相关。结论高血压患者存在机体自主神经功能受损,而合并有颈动脉硬化者可加重自主神经功能紊乱。

Objective To investigate the relationships of blood pressure variability （ BPV）, heart rate variability （HRV） and carotid intima - media thickness in patients with hypertension. Methods In 86 patients with hypertension and 42 healthy people, ambulatory blood pressure monitoring, dynamic electrocardiogram and carotid intima -media thickness were recorded and analyzed. Results The mean systolic blood pressure of different time, 24 hour systolic blood pressure standard deviation （24hSBP - SD） and daytime systolic blood pressure standard deviation （ dSBP - SD） were of significant difference between the two hypertension groups and control group ; at the same time, Mean systolic blood pressure of different time, 24 hSBP - SD and dSBP - SD of the intima - media thickening group （ IMT ） were significantly higher than those of pure hypertension group （PHt） and the control group. Compared with control group, heart rate variability of the two hypertension groups decreased ; moreover, standard deviation of the normal - to - normal interval （SDNN） of group IMT reduced significantly higher than those of group PHt and control group. The correlation analysis between BPV and HRV main indexes in group IMT found that 24 hSBP - SD, dSBP - SD were negatively correlated with SDNN, and positively correlated with LF/HF. Conclusion Patients with hypertension have autonomic nervous system function impairment, while the autonomic nervous disorders are aggravated with carotid artery sclerosis.