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高血压病左室肥厚患者心率变异及动态血压分析(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
1998年第2期
页码:
72-73,76
栏目:
论著
出版日期:
1998-03-01

文章信息/Info

Title:
Analysis of heart rate variability and ambulatory blood pressure in hypertensive left ventricular hypertrophy
作者:
王虹艳　马玉荣　赵香莲　曲 鹏
大连医科大学第二临床学院心血管内科 116023
Author(s):
Wang Hongyan;  Ma Yurong ;  Zhao Xianglian;  Qu Peng
Department of Cardiovascular Internal Medicine, Second Affiliated Hospital, Dalian Medical University, Dalian 116023
关键词:
心室肥厚;  左　心率变异性　昼夜节律;  血压
Keywords:
ventricular hypertrophy;  left　heart rate variability　circadia rhythm ;  blood pressure
分类号:
-
DOI:
-
文献标识码:
-
摘要:
观察高血压左室肥厚(LVH) 患者的心率变异(HRV)及血压昼夜节律变化, 以期了解三者之间的关系。选择伴有左心室肥厚的高血压病患者21例, 不伴有左心室肥厚的高血压患者28例, 选择年龄与患者可比的健康人25例作为正常对照组, 进行动态心电图及动态血压监测, 分析24 h HRV时域指标及血压昼夜节律。结果: 高血压伴左室肥厚患者HRV各指标均显著低于对照组(P<0.05) , 也比不伴左室肥厚患者进一步降低。PNN50昼夜节律明显减弱。动态血压结果显示: 不伴左室肥厚组与左室肥厚组血压昼夜节律消失者分别占各组总数的17.9% 及47.6%,组间比较差异显著(P<0.05)。结论: 副交感神经调节功能减弱可能与以上变化相关。高血压治疗应注意改善HRV ,重视恢复血压的昼夜节律。
Abstract:
Objective: To investigate the relationship between heart rate variability (HRV) and ambulatory blood pressure in hypertensive left ventricular hypertrophy (LVH). Methods: 28 hyperten sive patients without LVH and 21 with LVH, and 25 controls were recorded by Holter ECG and the 24 hour ambulatory blood pressure, HRV time domain were analysed. Results:Each parameter of HRV time domain in hypertensive patients with LVH were markedly lower than that in controls, the diurnal changes of PNN50were blunted. The disappearance rate of circadian changes of blood pressure in hypertensive patients with and without LVH was 17.9% and 47.6% (P<0.05).respectively. Conclusion: Decreased parasympathetic activity may be associated with these changes mentioned above, weshould pay attention to improving HRV and recovering circadian of blood pressure in the treatment for hypertension.

参考文献/References

［1］Pagani M , Lombardi F, Guzzeti S, et al. Power spectral analysis of heart rate and arterial pressure variabilities as a marker of sympatho-vagal interaction in man and conscious dog. Circ R es, 1986; 59: 178.

［2］Stein PK, Bosner MS, Kleiger RE, et al. Heart rate variability: A measure of cardiac autonomic tone. Am Heart J , 1994; 127: 1376.

［3］龚兰生, 刘力生. 血压昼夜变异及临床意义. 中华心血管病杂志, 1994; 22: 323.

［4］Devereus RB, Alonso DR, Lutas EM , et al. Echocardiographic assessment of left ventricular hypertrophy:Comparsion to necropsy findings. Am J Cardiol, 1986;57: 450.

［5］张维忠, 龚兰生, 邱慧丽, 等. 动态血压与高血压左室肥厚的关系. 中华心血管病杂志, 1993; 21: 138.

［6］Furlan R, Guzzetti S, Crivellaro W , et al. Continuous 24-hour assessment of the neural regulation of systemic arterial pressure and RR variabilities in ambulant subjects. Circulation, 1990; 81: 537.

备注/Memo

备注/Memo:
(收稿1997-06-02)
更新日期/Last Update: 1998-03-01