原发性高血压患者心率变异性的临床分析  

Clinical analysis of heart rate variability in essential hypertensive patients

作　　者：庄梅[1] 周元植[1] 

机构地区：[1]贵阳医学院附院心内科,550004

出　　处：《贵州医药》2002年第7期595-596,共2页Guizhou Medical Journal

摘　　要：目的探讨原发性高血压 (EH)患者自主神经功能变化。方法对 43例原发性高血压患者和 2 0例正常人进行Holter记录 ,分析对比心率变异性 (heartratevariability,HRV)指标。结果EH患者HRV的时域指标 (SDNN、SDNNi、RMSSD)及频域指标 (TP、LF、HF)较正常对照均明显降低 (P <0 0 0 1～ 0 0 5 ) ,以RMSSD、HF降低最为显著。EH患者LF HF较正常对照明显升高 (P <0 0 5 ) ,SDANN与对照组比较差异无显著性 (P >0 0 5 )。EH患者中 ,重度高血压组的时域、频域的多项指标较轻、中度高血压组降低 (P <0 0 1～ 0 0 5 )。极高危组的HRV多项指标亦较非极高危组减低 (P <0 0 1～0 0 5 )。结论原发性高血压患者存在迷走神经活性明显降低 ,同时伴有交感神经活性的相对增强。HRV的减低可能为预后不良的一个重要指标。Objective An investigation of autonomic nervous function was made in essential hypertensive patients. Methods Heart rate variability (HRV) was evaluated in 43 essential hypertensive patients and 20 healthy controls using 24-hour dynamic electrocardiographic recording.Results The levels of SDNN, SDNNi, RMSSD, TP, LF and HF in essential hypertensive patients were significantly lower than those in controls (P<0.001～0 05).There was a significant increase of LF/HF in essential hypertensive patients compared with that in controls (P<0.05). NO significant difference was found in SDANN between the essential hypertension group and control group. The levels of time and frequency domain measures in serious essential hypertension group were significantly lower than those in moderate and mild essential hypertension group (P<0.01～0.05). There was significant decrease of HRV in highly-critical-group compared with those in non-highly-critical-group (P<0.01～0.05). Conclusion The parasymathetic activity was significant decrease and the symathetic activity was relative increase in essential hypertnesive patients. The decrease of HRV was an important index in hypertensive mal-prognosis.

关 键 词：原发性高血压 心率变异性 临床分析 

分 类 号：R544.1[医药卫生—心血管疾病]