老老年高血压病患者血压昼夜节律对心率变异性的影响  

Influence of Blood Pressure Circadian Rhythm on Heart Rate Variability in Very Old Patients with Hypertension

作　　者：石洁[1] 胡元会[1] 商秀洋[1] 李宜[1] 吴华芹[1] 褚瑜光[1] 

机构地区：[1]中国中医科学院广安门医院

出　　处：《中西医结合心脑血管病杂志》2010年第11期1279-1280,共2页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

摘　　要：目的探讨老老年高血压病(EH)患者血压昼夜节律(BPCR)对心率变异性(HRV)的影响。方法应用24 h动态血压监测仪监测82例年龄≥80岁的EH患者血压水平,根据夜间血压下降率将患者分非杓型组和杓型组,测定两组患者的HRV指标。结果非杓型组的全程全部窦性R-R间期标准差(24 h SDNN)、全程全部窦性R-R间期的平方根(rMSSD)分别为100.30 ms±22.32 ms与116.32 ms±20.21 ms低于杓型组(P<0.05);非杓型组的两个相邻R-R间期相差≥50 s的心跳数所占心搏数的百分比(PNN50)为(4.3±2.8)%小于杓型组的(5.4±5.0)%(P<0.05)。结论夜间血压下降减少促进老年EH患者的心血管自主神经病变(CAN)进展。BPCR异常是老老年EH患者CAN的一个重要的独立预测指标,在老老年EH的防治中应重视夜间血压的控制,减少心脑血管事件的发生。Objective To investigate the influence of circadian blood pressure rhythm on heart rate variability（HRV） in the very old patients（≥80 years old） with hypertension.Methods Eighty-two very old patients were divided into two groups according to their blood pressure decreasing rate at night（10% into non-dipper group,≥10% into dipper group）.The circadian blood pressure rhythm and heart rate variability were measured respectively with ambulatory blood pressure monitoring and twenty-four hour electrocardiograph mornitoring.Results SDNN and RMSSD of non-dipper group was significantly decreased as compared with that of dipper group（P0.01）.The PNN50 in non-dipper group was lower than that in dipper group（P0.05）.Conclusion Abnormal BPCR was an independent determinant factor for the cardiovascular automatic neuropathy in very old patients with essential hypertension.

关 键 词：老老年高血压 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]