原发性高血压的心率变异性分析

Aualysis of heart rate variability of patients with essential hypertension

目的 通过观察原发性高血压患者心率变异性（ＨＲＶ）以及高血压患者血压昼夜节律正常与异常患者ＨＲＶ的变化，了解高血压患者心率变异性改变及血压昼夜节律异常与自主神经功能紊乱之间的关系。方法 对１００例原发性高血压患者进行２４小时动态血压监测，用时域分析法对心率变异性各项指标进行了检测，并与１００例血压正常组进行对照。结果 原发性高血压组与血压正常对照组相比，代表心率总变异程度的ＳＤＮＮ、ＳＤＡＮＮＩ和ＳＤＮＮＩ明显下降（Ｐ＜０．０１），代表迷走神经功能的指标ｒＭＳＳＤ和ＰＮＮ５０也有下降（Ｐ＜０．０５）。按照夜间血压下降百分率是否大于１０％将高血压组分为昼夜节律消失亚组和昼夜节律正常亚组，发现昼夜节律消失组ＨＲＶ的ＳＤＮＮ、ＳＤＡＮＮＩ、ＳＤＮＮＩ、ＲＭＳＳＤ和ＰＮＮ５０较昼夜节律正常组明显下降（Ｐ＜０．０１）。结论 原发性高血压患者心脏自主神经系统功能有一定损害，昼夜节律消失者的心脏自主神经系统功能损害较昼夜节律正常者更为严重。

Objective To investigate the heart rate variability (HRV) of patients with essential hypertension, and the HRV changes between the normal and abnormal circadian rhythm of blood pressure in essential hypertension. Methods 100 patients with essential hyper-tension by means of measuring the 24 horns ambulatory blood pressure and the heart rate variability compared with the normal controls (n = 100). Results The results showed that the patients with hypertension had lower rMSSD, PNN5O(P < 0.05) and SDNN, SDANNL,SDNNI( P <001) in comparing with the normal controls; and these changes had more significant descent in SDNN、SDANNI、SDNNI、RMSSD and PNN50(P <0.01)in the patients without circadian changes of blood pressure than those with such changes. Conclusion These results show that cardiac autonomic nervous system function was impaired in the patients with essential hypertension, more serious in abnormal circadian change of blood pressure than those in normal.