褪黑素和心率变异性与血压昼夜节律的相关性研究  

Relationship between melatonin and the circadian rhythm of blood pressure

作　　者：崔洪伟[1] 张忠霞[1] 高名同[1] 王美英[1] 宿爱华[1] 代会贞[1] 

机构地区：[1]潍坊医学院附属医院,山东潍坊261031

出　　处：《山东医药》2008年第34期10-12,共3页Shandong Medical Journal

摘　　要：目的探讨褪黑素(MLT)和心率变异性与血压昼夜节律的关系。方法将高血压患者及健康查体者分为非杓型高血压组、杓型高血压组及对照组,对其行24 h动态血压及心电图监测,测定白昼和黑夜尿6-羟基硫酸褪黑素(6-SMT)含量,分析心率变异性。结果非杓型高血压组夜间收缩压、舒张压及平均动脉压下降率均低于杓型高血压组和对照组(P<0.01)。各组黑夜尿6-SMT含量高于白昼,非杓型高血压组黑夜尿6-SMT含量和黑夜/白昼尿6-SMT比值低于杓型高血压组和对照组(P均<0.01)。各组黑夜/白昼尿6-SMT比值与夜间血压下降率均存在正相关(P均<0.05)。非杓型高血压组总体标准差、均值标准差、标准差均值、均方根值低于杓型高血压组和对照组,杓型高血压组低于对照组(P均<0.05)。结论MLT黑夜分泌较多,与血压昼夜节律异常存在密切关系;血压昼夜节律异常者有更明显的心率变异性受损。Objective To compared with urine 6-sulfatoxymelatonin （6-SMT） in the daytime and nighttime in some people, whose circadian rhythm of blood pressure was normal or not, in order to study the relationship of circadian rhythm of blood pressure, melatonin（MLT）and heart rate variability. Methods 88 persons included healthy people, in-patients and outpatients in cardiovascular department were divided into three groups： non-dipping group, dipping group and control group. Urine 6-SMT levels were determined and ratio of nighttime/daytime urine 6-SMT levels was calculated, 24-hottr ECG and blood pressure were monitored. Results The rhythm of blood pressure is non-dipping in non-dipping group, but the rhythm of blood pressure is dipping both in dipping group and. control group. Decreasing ratio of systolic blood pressure , diastolic blood pressure and mean arterial blood pressure in the nighttime were all lower in non-dipping group than in dipping group and control group respectively（ P 〈 0.01 ）. Urine 6-SMT levels in the nighttime were all higher than that in the daytime in non-dipping group, dipping group and control group respectively（P 〈 0.01 ）. Nighttime urine 6-SMT levels and ratio of nighttime/daytime urine 6-SMT levels were lower in non-dipping group than dipping group and control group respectively（ P 〈 0.01 ）. It showed positive correlation between ratio of nighttime/daytime urine 6-SMT levels and decreasing ratio of blood pressure in the nighttime in all three groups （ P 〈 0.05 ）. Conclusions The secretion of MLT has circadian rhythm which is lower in the daytime and higher in the nighttime. The secretion of MLT in the nighttime is related to disorders of circadian rhythm of blood pressure.

关 键 词：褪黑素 6-羟基硫酸褪黑素 心率变异性 血压昼夜节律 

分 类 号：R544.1[医药卫生—心血管疾病]