老年高血压患者血压的动态变化与心率变异的相关性

The relationship between the dynamic changes of blood pressure and heart rate variability in elderly patients with hypertension

目的:探讨老年高血压患者血压昼夜动态变化与心率变异的相关性。方法:选取收治的老年高血压患者70例作为观察组,另选取体检健康人员50例作为对照组。对所有研究对象进行24 h动态血压监测,并采用时域分析法检测所有对象心率变异性(HRV),对比观察组与对照组HRV指标差异性;根据观察组夜间血压下降分数分为节律正常亚组与节律消失亚组,比较节律消失亚组与节律正常亚组患者HRV各项指标差异性。结果:观察组患者与对照组比较HRV各项指标均明显下降,SDNN、SDANN、RMSSD及PNN50差异比较,存在统计学意义(P<0.05);节律正常亚组与节律消失亚组患者HRV各项指标SDNN、SDNN5、SDANN、RMSSD、PNN50比较均存在显著差异(P<0.05)。结论:老年高血压患者合并的自主神经反射机制障碍可导致血压与自主神经之间的关系成相反趋势变化,并且自主神经功能紊乱在老年高血压昼夜节律消失的患者中更为严重。

Objective To discuss the correlation of the dynamic changes of blood pressure and heart rate variation of elderly with hypertension. Method 70 cases with elderly hypertensive,which admitted in our hospital,were selected as the observation group and 50 cases medical health personnel were selected as the control group. The entire research object was given 24 hours ambulatory blood pressure monitoring. All objects and heart rate variability（ HRV） were detected by time- domain analysis method.The observation group was divided into rhythm normal subgroups and rhythm disappeared subgroups according to the night blood pressure drop points. HRV differences in the indicators of the two groups were compared. Results HRV indicators compared with control group in observation group were significantly lower,SDNN,SDANN,RMSSD and PNN50 was statistical significance（ P〈0. 05）. The HRV indicators SDNN,SDNN5,SDANN,RMSSD,PNN50 of rhythm normal subgroups and rhythm disappeared subgroups were significant differences（ P〈0. 05）. Conclusion In elderly patients with hypertension disorder of autonomic nervous reflex mechanism can lead to the relationship between blood pressure and autonomic nerve into the opposite trend,and autonomic nerve dysfunction in elderly patients with high blood pressure circadian rhythm disappeared.