伴脑血管意外的Ⅲ期高血压病患者心脏自主神经活性昼夜节律研究

Studies on cardiac autonomic nervous activity and its circadian rhythm in essential hypertensives with cerebrovascular accident

目的 研究伴脑血管意外、神志清楚的Ⅲ期高血压病患者心脏自主神经活性昼夜节律的改变。方法 对 4 5例尚未治疗的伴脑血管意外、神志清楚的Ⅲ期高血压病患者 (研究组 )和 5 2例Ⅰ～Ⅱ期高血压病患者 (高血压对照组 )、 4 0例体检正常者 (正常对照组 )进行Holter监测 ,对其心功率谱昼夜节律进行比较。结果 研究组昼、夜的低频标准单位 (LFnu)、高频标准单位 (HFnu)、LF/HF的均值间差别均无显著性意义 (P >0 0 5 ) ;3组的 3项指标在白天的差别均无显著性意义 (P >0 0 5 ) ,而夜间的差别均有显著性意义 (P <0 0 5 )。结论 研究组交感、副交感神经活性及其平衡调节能力均丧失昼夜节律 ,主要表现为在夜间研究组较Ⅰ～Ⅱ期组交感神经活性亢进。

Objective To study cardiac autonomic nervous activity and its changes of the circadian rhythm in the third stage essential hypertensive with conscious cerebrovascular accident.Methods In 45 the third stage essential hypertensives (EHⅢ group) and 52 the first to second stage essential hypertensives (EHⅠ-Ⅱ group) and 40 normal people(control group) 24 hour dynamic ECG monitorings were performed before drug therapy.Quantitative analysis Lfnu,Hfnu,LF/HF with HRPSA method and compared the results in three groups.Results There were no significant differences in the value of EHⅢ,Lfnu,Hfnu,LF/HF between daytime and nighttime (P>0 05).There were significant differences in the value of Lfnu,Hfnu,LF/HF among three groups during nighttime (P<0 05),but they were no difference during daytime (P>0 05).Conclusion The impairments of autonomic nervous system or its loss of the circadian rhythm in EHⅢ group were more obvious than EHⅠ-Ⅱ group.It showed that the double damaging - cardiac sympathetic tone was increased but cardiac parasympathetic activity and balance modulating ability were decreased in EHⅢ especially during nighttime.