高血压病病人治疗前后24h血压变异性和心率变异性观察  

The Study of 24-Hour Blood Pressure Variability, Heart Rate Variability Before and After Treatment in Essential Hypertensives

作　　者：刘勇[1] 杨涛[1] 

机构地区：[1]四川省自贡市第二人民医院

出　　处：《中西医结合心脑血管病杂志》2003年第9期498-500,共3页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

摘　　要：目的 :①研究高血压病人 2 4h血压变异性和心率变异性的规律 ;②观察依那普利对高血压病人血压变异性和心率变异性的治疗影响。方法 :①对 13 2例高血压病人 (EHⅠ -Ⅱ组 90例 ,EHⅢ组 42例 )和 60例健康对照进行 2 4h动态血压监测并分析血压变异性和心率变异性 ;②对 45例EHⅠ -Ⅱ组高血压病人用依那普利随机单盲法治疗前后分析血压变异性和心率变异性指标做自身前后对照研究。结果 :①EHⅠ -Ⅱ组和EHⅢ组的 2 4h、白天、夜间各时段的收缩压和平均血压变异性指标均大于正常对照组(P <0 .0 1或P <0 .0 5 ) ,EHⅠ -Ⅱ组各时段的舒张压变异性和夜煎平均血压变异性与对照组比较无统计学意义 (P >0 .0 5 ) ,EHⅢ组高血压病人的舒张压变异性明显大于对照组(P <0 .0 5 ) ;②EHⅢ组与EHⅠ -Ⅱ组比较各时段的收缩压、舒张压、平均血压变异性均明显增大 (P <0 .0 5或P <0 .0 1) ;③依那普利治疗前后各时段的收缩压、舒张压、平均血压变异性和 2 4h心率变异性、夜间心率变异性比较均无统计学意义 (P >0 .0 5 ) ,仅治疗后白天时段的心率变异性较治疗前显著减小(P <0 .0 5 )。结论 :高血压病人在血压平均值升高的同时 ,血压变异性 (尤其是SBPV )也明显高于正常人 。Objective:①To study 24-hour blood pressure variability(BPV)、heart rate variability(HRV) in essential hypertensives(EH);②To observe the effects of enalapril on BPV、HRV in the patients. Methods:①BPV and HRV were evaluated in 132 EH patients (EHⅠ-Ⅱgroup 90、EHⅢ group 42) using ambulatory blood pressure monitoring, and compared with 60 normal controls; ②45 EHⅠ-Ⅱ patients were treated with enalapril for 4 weeks by randomized single-blind study, the BPV、HRV were measured before and after treatment. Results:①The SBPV and MAPV during 24-hour period、daytime or nighttime were significantly higher both EHⅠ-Ⅱ and EHⅢ than control group(P<0.01 or P<0.05), but the DBPV was higher only in EHⅢ than control group (P<0.05);②The SBPV、DBPV or MAPV during every interval were higher apparently in EHⅢ than EHⅠ-Ⅱ(P<0.05 or P<0.01);③The SBPV、DBPV、MAPV during three intervals and 24-h HRV、nighttime HRV were no differences between pre and post treatment (P>0.05), uniquely daytime HRV was reduced obviously after VS before treatment (P<0.05). Conclusion:There was a significant increase in BPV (especially in SBPV) and in particular EHⅢ group than control group; there was no effect in BPV with EHⅠ-Ⅱ group by enalapril treatment for 4 weeks, but HRV during daytime was declining after treatment.

关 键 词：高血压病 药物治疗 24h血压变异性 心率变异性 依那普利 

分 类 号：R544.1[医药卫生—心血管疾病]