高血压病心脏迷走神经活性及昼夜节律研究

Studies on cardiac vagus nerve activity and circadian rhythm in patients with essential hypertension

目的 :检测原发性高血压患者和正常人的心脏迷走神经活性及其昼夜节律变化 ,同时探讨心脏迷走神经活性与血压之间的关系。方法 :选择原发高血压患者和正常人 ,同时进行动态心电图和动态血压检测 ,以分析原发高血压患者和正常人心率变异参数差异及昼夜节律变化和血压与心率变异参数的关系。结果 :高血压病患者与正常人比较 ,2 4h、清醒和睡眠期HF及PNN50 均明显降低 (P <0 .0 0 1) ;高血压病患者HF、PNN50 仍可见昼夜节律变化 :HF、PNN50 在睡眠期较高 (P <0 .0 0 1)但昼夜差异明显比正常人小 (P <0 .0 0 1) ;2 4h总的HF与SBP、DBP负相关 (r =- 0 .74 ;- 0 .83,P =0 .0 0 0 1)结论 :高血压病患者心脏迷走神经活性降低 ;心脏迷走神经活性昼夜节律尚存 ,但昼夜变化幅度明显减小 ;迷走神经活性的消长与血压的波动有关。

Objective:To measure the cardiac vagus nerve activity and its circadian rhythm in patients with essential hypertension(EH group) and normontensive controls (NC group),and to study the relationship between the cardiac vagus nerve activity and blood pressure.Methods:By dynamic electrocardiogram and ambulatory blood pressure monitoring,HF,PNN 50 and their circadian rhythm were compared between the EH group and NC group,and the relationship between HF,PNN 50 and blood pressure was analyzed.Results:During 24 hours,waking and sleeping hours,HF,PNN 50 were significantly lower(P<0.001)in EH group compared with NC group.HF,PNN 50 in EH group still remained a circadian rhythm:HF,PNN 50 were higher during the sleeping hours(P<0.001),but their night-day differences were significantly smaller in EH group than that in NC group(P<0.001).HF and PNN 50 were inversely correlated with SBP,DBP during 24 hours(r=-0.74;-0.83,P=0.0001).Conclusion:In patients with essential hypertension,the cardiac vagal activity decreases;the circadian rhythm of its activity is markedly blunted.The changes in the cardiac vagus activity are correlated with blood pressure oscillations.