高血压病患者血压变异、心率变异、QT变异及其相关性研究

AMBULATORY BLOOD PRESSURE VARIABILITY,HEART RATE VARIABILITY, QT VARIABILITY AND THEIR RELATIVITY OF ESSENTIAL HYPERTENSION

目的 :研究高血压病 (EH)患者血压变异、心率变异、QT变异及其相关性 ,并探讨β受体阻滞剂对心脏自主神经功能的改善。方法 :88例研究对象分为正常对照组 ( 组 )、高血压病未治疗组 ( 组 )及高血压病 β受体阻滞剂治疗组 ( 组 )。均同时佩带 2 4h动态血压和动态心电图纪录盒。结果 :(1)血压变异指标 : 组 2 4h、昼间、夜间ABPVs均大于 组 , 组与 组间 2 4h及昼间 ABPVd有显著差异。 组 2 4h、昼间及夜间平均 SBP、平均 DBP显著高于 组及 组。 (2 )心率变异指标 : 组 2 4h、昼间、夜间 SDNN显著高于 组 ; 组昼间 SDNN显著高于 组。 组昼间、夜间 HFnorm显著高于 组 ; 组昼间 L Fnorm、昼间及夜间 HFnorm高于 组。 (3) QT变异度 : 组及 组QT变异度昼间大于夜间 , 组昼、夜间 QT变异度无显著差异。 (4 )三组指标的相关性 : 组伴 L VH者昼间 ABPVs与 SDNN、昼间平均 SBP与 SDNN、夜间平均 DBP与 SDNN以及 2 4h SDNN与 QTv均呈正相关 ,而夜间平均 DBP与HFnorm呈负相关。结论 :(1) EH患者血压变异增大 ,昼夜波动节律消失 ,心率变异性降低 ,QT变异度昼夜无显著差异。 (2 ) EH伴 L VH者血压变异与心率变异、心率变异与 QT变异间存在一定程度的相关。 (3)β受体阻滞剂可一定程度增加心率变异 ,降低血?

Objective: To investigate the changes of ambulatory blood pressure variability(ABPV),heart rate variability(HRV),QT variability(QTv) in essential hypertension(EH),and study their relativity. To evaluate the effect of beta-adrenergic blocker on autonomic nervous system. Methods: 19 controls,38 EH patients without therapy and 30 EH patients with the therapy of beta-adrenergic blocker all received 24h ambulatory blood pressure and 24h Holter eletrocardiogram measurement. Results:(1)ABPV:24h,daytime and nighttime ABPVs of EH without therapy were higher than control, 24h,daytime and nighttime average SBP,DBP of EH without therapy were higher than control and EH with therapy.(2)HRV: 24h,daytime and nighttime SDNN of control were significantly higher than EH without therapy, significant difference was found in daytime SDNN between two EH groups; Daytime and nighttime HFnorm of control were higher than EH without therapy, daytime LFnorm, daytime and nighttime HFnorm had difference between two EH groups. (3)Daytime QTv was significantly higher than nighttime in control and EH with therapy.(4)In EH with LVH and EH without therapy, there were positive relations between daytime ABPVs and SDNN, daytime average SBP and SDNN, nighttime average DBP and SDNN,24h SDNN and QTv; there was negative relations between night average DBP and HFnorm. Conclusion:(1)In EH patients ABPV were increased, HRV were reduced,the rhythm of blood pressure were disappeared, no significant difference was found between daytime and nighttime QTv.(2)There were relations between ABPV and HRV, HRV and QTv.(3) ABPV,HRV and the rhythm of BP can be improved by beta-adrenergic blocker.