老年高血压患者血压昼夜节律变化与心率变异及颈动脉弹性功能的相关性  

Relationship of day-night rhythm of blood pressure with heart rate variability and carotid artery elasticity in elderly patients with hypertension

作　　者：许伟[1] 徐伯平[1] 

机构地区：[1]南京医科大学第一附属医院老年科,江苏省南京市210029

出　　处：《实用老年医学》2008年第1期33-35,共3页Practical Geriatrics

摘　　要：目的探讨老年高血压患者血压昼夜节律变化与心率变异、颈动脉弹性功能的相关性。方法我科2005～2006年老年高血压患者56例,用动态血压观察血压昼夜节律,根据夜间血压下降率[夜间平均收缩压(nMSP)与白天平均收缩压(dMSP)比值]分组,nMSP/dMSP≥100%为反杓型组,nMSP/dMSP≤90%为杓型组,90%<nMSP/dMSP<100%为非杓型组。用动态心电图测定时域值和频域值,用彩色多普勒超声检测患者颈动脉血流受阻情况。结果心率变异频域指标低频和高频比率(LF/HF)随着nMSP/dMSP升高而下降,3组之间有显著性差异(P<0.05)。颈部动脉阻力指数(RI)随nMSP/dMSP比值升高有增加趋势,其中右侧颈总动脉RI在杓型组与反杓型组以及杓型组与非杓型组有显著性差异(P<0.05),左侧椎动脉RI在杓型组与反杓型组以及非杓型组与反杓型组有显著性差异(P<0.05),右侧椎动脉RI在杓型组与反杓型组有显著性差异(P<0.05)。结论老年高血压患者血压昼夜节律同自主神经功能及颈动脉弹性功能有相关性。Objective To investigate the relation of day-night rhythm of blood pressure with heart rate variability and carotid artery elasticity in elderly patients with essential hypertension. Methods Fifty-six hospitalized cases from 2005 to 2006 were divided into three groups ： reverse-dipping group （ nMSP/dMSP≥100% ）, non-dipping group （ 90% 〈 nMSP/dMSP 〈 100% ） and dipping group （ nMSP/dMSP≤ 90% ）, according to their blood pressure-decreasing ratio by night to day mean systolic blood pressure （nMSP/dMSP） with ambulatory blood pressure monitoring（ABPM）. The indexes of time domain and frequency domain, resistance index（RI） of carotid artery were measured respectively by the 24 h dynamic electrocardiography and color Doppler uhrasonography. Results A significant decrease was observed in the ratio of low frequency to high frequency （LF/HF） with nMSP/dMSP rising in all the three groups （ P 〈 0. 05 ）. There was a growing tendency of RI along with increase of nMSP/dMSP,which was significantly different as for the common carotid artery in the right side and bilateral arteriae vertebralis. Conclusions Day-night rhythm of blood pressure has significant correlation with autonomic nerve＇s function and the function of carotid artery elasticity.

关 键 词：高血压 血压昼夜节律 心率变异 颈动脉弹性 老年人 

分 类 号：R544.1[医药卫生—心血管疾病]