降压治疗对老年高血压合并脑梗死患者心率变异性的影响分析

Effect of antihypertensive therapy on heart rate variability in elderly hypertensive patients with cerebral infarction

目的研究降压治疗对老年高血压合并脑梗死患者心率变异性(HRV)的影响,观察不同病理状态下患者HRV变化状况。方法选取2015年1月～2017年1月我院心血管内科收治的72例高血压合并脑梗死患者纳入观察组,选取同期健康体检老年人18例纳入对照组,两组基线资料比较,差异无统计学意义(P> 0.05),具有可比性,实验开始均检测HRV各指标参数,观察组予降压治疗,首次降压与二次降压后再次检测HRV各指标参数,将观察组降压治疗前后的HRV各指标参数与对照组进行比较,观察老年高血压合并脑梗死患者不同血压水平下的HRV变化情况。结果降压治疗前观察组HRV各指标参数与对照组相比明显减低,差异有统计学意义(P <0.05),首次降压后HRV各指标参数与降压治疗前相比明显增高,差异有统计学意义(P <0.05),二次降压后SDNN、SDANNI与首次降压相比明显增高,差异有统计学意义(P <0.05)。结论高血压合并脑梗死患者的心率变异性均有不同程度减低,积极进行降压治疗能够有效提高患者心率变异性,对改善自主神经功能有利。

Objective To study the effect of antihypertensive therapy on heart rate variability（HRV） in elderly hypertensive patients with cerebral infarction, and to observe the HRV changes in patients with different pathological conditions. Methods From January 2015 to January 2017, 72 cases of hypertension with cerebral infarction treated in cardiovascular medicine department of our hospital were included in the observation group, at the same period, 18 cases of healthy elderly persons were selected and included in the control group. There was no significant difference in baseline data between the two groups（P 〉0.05）. All parameters of HRV were detected at the beginning of the experiment. The observation group received antihypertensive therapy, the parameters of HRV were detected again after the first antihypertensive treatment and second antihypertensive treatment. Before and after antihypertensive treatment, the HRV parameters of observation group were compared with the control group, the change of HRV in different blood pressure levels of aged patients with hypertension complicated with cerebral infarction were observed. Results Before antihypertensive treatment, the parameters of HRV in observation group were significantly lower than those in control group（P 〈0.05）, and the parameters of HRV after the first antihypertensive treatment were significantly higher than those before antihypertensive treatment, with statistical differences（P 〈0.05）. The SDNN and SDANNI after the second antihypertensive treatment were significantly higher than those of the first antihypertensive treatment, the difference was statistically significant（P 〈0.05）. Conclusion The heart rate variability of hypertensive patients with cerebral infarction is reduced to varying degrees in varying degrees. Active antihypertensive therapy can effectively improve the heart rate variability of patients and improve autonomic nervous function.