高血压并靶器官损害患者心率变异性分析及护理  

Analyzing and nursing of the relevance between Heart Rate Variability(HRV) and target organ damage of Hypertension patients

作　　者：曾伟[1] 郭慧梅[1] 张晓晖[1] 杨朝霞[1] ZENG Wei GUO Hui-mei Zhang Xiao-hui YANG Zhao-xia(The Affiliated Hospital of Taishan Medical University ,Taian 271000, China)

机构地区：[1]泰山医学院附属医院,山东泰安271000

出　　处：《泰山医学院学报》2016年第6期640-642,共3页Journal of Taishan Medical College

摘　　要：目的探讨高血压及高血压并靶器官损害患者心率变异性与高血压并靶器官损害的相关性,了解心脏自主神经功能状态,反映自主神经受损程度,指导临床治疗和护理。方法选择高血压患者80例作为研究对象,其中单纯高血压患者40例,高血压伴靶器官损害40例,选择同期健康体检血压正常者40例,作为对照组进行比较和对照,每组患者均进行动态心电图检测,获取心率变异性各参数(SDNN、SDANN、r MSSD、PNN50、LF、HF、LF/HF)的相关值,分析各组之间心率变异性各参数的变化,并进行组间比较。结果心率变异性各参数中,SDNN、SDANN、r MSSD、PNN50、HF的参数值,单纯高血压组明显低于正常血压组,两组相比较,P<0.05;伴靶器官损害组以上各参数进一步降低,与血压正常组比较,P<0.05,与单纯高血压组比较,r MSSD:P>0.05,其余各参数,P<0.05;频域指标中的LF、LF/HF参数值,单纯高血压组高于血压正常组,两组相比较,P<0.05;伴靶器官损害组增高更明显,与正常对照组相比,P<0.05,与单纯高血压组比较,LF:P>0.05,LF/HF:P<0.05。结论高血压患者的心率变异性时域指标的降低以及部分频域指标的增高,说明心脏交感神经张力增高,迷走神经张力降低,心脏自主神经功能受损,尤其是高血压并靶器官损害患者自主神经功能受损更加严重,心脏自主神经功能紊乱与高血压及高血压伴靶器官损害的发生发展直接相关。Objective： To explore the relevance between Heart Rate Variability（ HRV） and target organ damage of patients with hypertension or patients with hypertension and target organ damage,to understand the function of cardiac autonomic nervous system and reflect the degree of autonomic nerve damage,and to guide clinical treatment and nursing. Methods： To select 80 patients with hypertension as the research object,including 40 hypertension patients with target organ damage and 40 hypertension patients. 40 patients with normal blood pressure were selected as the control group during the same period. The dynamic electrocardiogram（ ECG） was detected in each group,and the correlation parameter values of heart rate variability（ SDANN,SDNN,LF,r MSSD,PNN50,LF/HF,HF） were obtained. Then analysing the changes in each group for comparison between groups. Results： SDNN,SDANN,r MSSD,PNN50,HF of simple hypertension group was significantly lower than that of the normal control group（ P〈0. 05、P〈0. 01）. Further reduction showed in group with target organ damage above parameters. Compared with group with normal blood pressure,the result is P〈0. 01. Compared with the simple hypertension group,the result is P〈0. 05、P〈0. 01 but r MSSD（ P〈0. 05）. LF,LF / HF of the simple hypertension group was higher than that of group with the normal blood pressure（ P〈0. 01）. Further increase showed in group with target organ damage above parameters. Compared with group with normal blood pressure,the result is P〈0. 01. Compared with the simple hypertension group,the result is P〈0. 05（ LF） 、P〈0. 01（ LF / HF）. Conclusions： Time domain index of HRV decreased and frequency domain index increased in patients with hypertension showed that cardiac sympathetic nerve tension increased,ecreased vagal tone d,impaired cardiac autonomic nerve function,especially the damage of cardiac autonomic nerve in patients with hypertension target organ damage is more serious,cardiac autonomic dysfunction was directl

关 键 词：高血压 心率变异性 靶器官损害 护理 

分 类 号：R473.5[医药卫生—护理学]