妊娠高血压综合征病人的心率变异性研究

Heart Rate Variability in Patients with Pregnancy Induced Hypertension

目的 :观察妊娠高血压综合征 (妊高征 ,PIH)病人与正常孕妇心率变异性 (HRV)变化 ,以探讨两种状态下交感神经和副交感神经活动、交感神经与副交感神经张力平衡的情况及机理。方法 :2 1例正常孕妇为对照组 (CON组 )。 5 5例妊高征患者分为PIH1组 (轻度妊高征 ) 2 1例 ,PIH2 组 (中度妊高征 ) 19例 ,PIH3 组 (重度妊高征 ) 15例。观察全天HRV变化。结果 :与对照组比较 ,PIH1组、PIH2 组和PIH3 组的LF/HF皆升高 (2 .2 1±0 6 5 ,2 .33± 0 .78,4 .5± 1.2 1vs 1.78± 0 .70 ) ,差异有显著意义 (P <0 .0 5或P <0 .0 1)。PIH3 组的HF降低(131.0 3± 6 1.5 9vs 2 4 5 .6 1± 12 1.0 3)ms2 ,LF升高 (5 2 6 .77± 10 7.32vs 389.4 0± 16 6 .5 1)ms2 ,差异有显著意义 (P<0 .0 5 )。PIH1组、PIH2 组HF和LF与对照组无差异。结论 :妊娠高血压综合征患者存在交感神经和副交感神经平衡紊乱 ,重度妊高征病人交感神经活动显著增强 。

Objective:To study whether cardiovascular changes in pregnancy-induced hypertension are associated with the increase of sympathetic function,the decrease of vagal function and changes of sympathovagal balance. Method: HRV( LF,HF,LF/HF) in the whole day was assessed in 21 patients with mild pregnancy-induced hypertension(Group PIH1),21 patients with moderate pregnancy-induced hypertension(Group PIH2), 15 patients with severe pregnancy-induced hypertension (Group PIH3) and 21 healthy pregnant women(Control). Results: LH/HF in Group PIH1, Group PIH2 and Group PIH3 increased markedly ((2.21±0.65, 2.33±0.78, 4.5±1.21 vs 1.78±0.70, P<0.05 or P<0.01) in comparison with control.In Group PIH3, HF decreased significantly (131.03±61.59 vs 245.61±121.03, P<0.05),LF increased significantly (526.77±107.32 vs 389.40±166.51 ,P<0.05) as compared with control. Conclusions: sympathovagal balance is disturbed in pregnancy-induced hypertension, as shown by increased LH/HF.The sympathetic function appears to be increased and parasympathetic function decreased markedly in patients with severe pregnancy-induced hypertension.