原发性高血压患者昼夜心率变异性分析

Circadian Variation of Heart Rate Variability in Hypertensive Patients

目的 通过 86例原发性高血压病 (EH)患者的昼夜心率变异性 (RHV)分析 ,探讨EH患者植物神经功能状态的改变情况。方法 对受检者进行昼夜 2 4h动态心电图 (DCG)监测 ,选用HRV参数中具代表性的时域指标SDNN ,rMSSD及PNN50 进行分析。结果 EH患者HRV分析中的各参数指标均降低 ;3级EH患者HRV指标低于 1～ 2级EH患者 ;反映EH患者夜间 (2 3时～次日 6时 )迷走神经活性的rMSSD及PNN50 明显降低 ,其变化大于昼夜 2 4h。结论 HRV分析参数可作为评估EH患者病程和病情的指标 ,EH患者昼夜植物神经功能状态发生紊乱、调控受损 ,夜间迷走神经活性损害表现更明显。

Objective By analysizing the circadian variation of heart rate variability(HRV) in 86 cases of patients with elementary hypertention (EH),the functions of autonomic nervous systems in hypertensive patients were evaluated.Method 24 hours of dynamic electrocardiogram (DCG) of examine were measured and the representative time domain indexes of SDNN,rMSSD,and PNN 50 among HRV parameters were analysized.Result The parameters of HRV in EH patients were lowered and those of 3 scales of EH patients were lowerer than those of 1 or 2 scales of ones.The parameters of rMSSD and PNN 50 at night (23pm～6am) in EH patients,reflecting parasympathetic activities,were significantly reduced and were lowerer than those of 24 hours of circadian variation.Conclusion The functions of autonomic nervous systems in patients with EH were disordered and the injury of parasympathetic nervous systems were significantly represented at night.The parameters of HRV can regard as one index of state of illness in EH patients.