原发性高血压患者动态血压昼夜节律变化与心率变异的关系

Relation between rhythm of blood pressure and heart rate variability in essential hypertension

目的 观察原发性高血压 (EH )患者的血压昼夜节律的变化与心率变异的关系。方法 对 10 3例原发性高血压患者进行 2 4h动态血压检测 ,并用时域分析法对心率变异性 (HRV)各项指标进行检测 ,并与 6 0例正常对照 (NC)组比较。结果 心率总变异程度的SDNN(2 4h正常RR间期标准差 ) ,SDANNI(2 4 0 8h平均RR间期标准差 )明显下降(P <0 0 5 )。按照夜间血压下降百分率将原发性高血压病人分为节律消失组、节律正常组 ,并分别与正常对照组比较 ,发现节律消失组HRV各项指标下降更为显著 ,SDNN、SDAN NI、SDNNI(2 4 0 8h正常RR间期标准差均值 )不但显著低于正常对照组 (P <0 0 5 ) ,也显著低于节律正常组 (P <0 0 5 )。结论 原发性高血压患者中节律消失者的心脏自主神经系统功能损害更为严重 ,HRV对评价高血压病对靶器的损害及预后有重要的临床意义。

Objectives To investingate the relationship between the ciradin rhythm of blood pressure and the heart rate variability in essential hypertension. Methods 103 cases of hypertensive disease were studied by means of the 24h ambulatory blood presssure monitoring and the heart rate variability. Results The patients with hypertension had lower SDNN and SDANNI as compared with the normal controls(n=60,P<0.05)and these changes had more significance(SDNN,SDANNI and SDNNI, P<0.05)in the patients without ciradin changes of blood pressure than those with such changes.Conclusions Cardiac autonomotropic function is impaired more in the former than in the later patients. The RHV in different perious and levels may be important indicators in evaluating target-organ-damage(TOD)of hypertension.