高血压病合并睡眠结构紊乱患者血压水平与心率变异性相关性研究

Clinical Features of Essential Hypertension with Sleep Disorder and Its Correlation with Heart Rate Variability

目的观察高血压病合并睡眠结构紊乱患者的血压水平与心率变异性的相关性。方法收集185例高血压病患者,根据国际分类标准分为睡眠结构紊乱组105例、非紊乱组80例,根据是否给予干预措施将睡眠结构紊乱组随机分为治疗组53例和对照组52例进行临床观察,具体观察指标包括24 h动态血压及心率变异性相关指标。结果根据国际分类标准分为睡眠结构紊乱105例(56.8%,105/185),非紊乱组80例(43.2%,80/185)。睡眠结构紊乱组的白天及夜间平均血压均高于非睡眠结构紊乱组(P<0.05),心率变异性指标均低于非睡眠结构紊乱组(P<0.05)。多因素Logistic回归分析显示,心率变异性中的SDANN、RMSSD减小是高血压病合并睡眠结构紊乱的独立危险因素(P<0.05);与对照组比较,治疗组治疗前后24 h动态血压、心率变异性指标较对照组增大(P<0.05)。结论与非紊乱组高血压病患者相比,睡眠结构紊乱的高血压病患者血压升高幅度大、心率变异性小;与对照组比较,治疗组24 h动态血压、心率变异性指标较对照组增大;因此积极进行抗睡眠结构紊乱治疗可能更有利于降压效果和改善心率变异性异常。

Objective To observe the relationship between clinical characteristics of essential hypertension complicated with sleep disorder and heart rate variability and explore its correlation with sleep disorders.Methods A total of 185 patients with essential hypertension were collected.According to the international classification criteria, they were divided into two groups(sleep disorder 105 cases and non-disorder 80 cases).The sleep disorder group was randomly divided into treatment group(53 cases) and control group(52 cases) for clinical observation according to whether intervention measures were given or not.The specific observation indexes included 24 h ambulatory blood pressure and heart rate variability related indexes.Results According to international classification standards, 105 cases(56.8%,105/185) were classified into sleep disorder group and 80 cases(43.2%,80/185) were classified into non-disorder group. The average blood pressure in daytime and nighttime in the sleep disorder group was higher than that in the non-sleep disorder group(P<0.05),and the index of heart rate variability was lower than that in the non-sleep disorder group(P<0.05).Multivariate Logistic regression analysis showed that the decrease of SDANN and RMSSD in heart rate variability was an independent risk factor for hypertension complicated with sleep disorder(P<0.05).Compared with the control group, the indexes of 24 h ambulatory blood pressure and heart rate variability in the treatment group were increased before and after treatment(P<0.05).Conclusion Compared with non-disordered patients with essential hypertension, sleep disorder patients with essential hypertension have higher blood pressure and smaller heart rate variability.Compared with the control group, the indexes of 24 h ambulatory blood pressure and heart rate variability in the treatment group were larger than those in the control group.Therefore, active anti-sleep disorder treatment may be more conducive to anti-hypertensive effect and improvement of abnormal heart rate variability.