不同血压分级的原发性高血压患者心率变异性分析

目的 探讨不同高血压分级患者的心率变异性（HRV）特征,了解高血压对自主神经功能的影响.方法 纳入2011年6月-2012年6月我院心内科高血压患者（n=167）及健康对照组（n=50）,进一步根据〈中国高血压防治指南〉血压分级标准将高血压组分为：高血压1级组140 mmHg≤收缩压（SBP）＜160 mmHg和/或90 mmHg≤舒张压（DBP）≤100 mmHg,n=45]、高血压2级组（160≤SBP＜180 mmHg和/或100 mmHg≤DBP≤110 mmHg,n=57）、高血压3级组（SBP≥180 mmHg和/或DBP≥110 mmHg,n=65）,采用24小时动态心电图记录的各组研究对象的HRV资料,分析和比较各组间HRV的5项时域指标SDNN、SDANN、HRV三角指数、RMSSD、PNN50之间的差异.结果 3组高血压组的5项HRV时域指标均低于健康对照组（P＜0.05）;高血压1级组、高血压2级组、高血压3级组三组之间的5项时域指标依次降低,其中SDNN、SDANN、HRV三角指数在对照组、高血压1级组、高血压2级组、高血压3级组任意两组之间比较,差异均具有统计学意义（P均＜0.05）.结论 高血压患者存在自主神经功能受损,并且随着血压分级水平的升高,自主神经受损逐渐加重.

Heart rate variability in essential hypertensive patients with different grades of blood pressure

Objective To investigate the features of heart rate variability （HRV） in essential hypertensive patients with different grades of blood pressure （BP）, and to understand the influence of hypertension on autonomic nervous function. Methods The hypertensive patients （hypertension group, n=167） and healthy population （control group, n=50） were chosen from June 2011 to June 2012, and then hypertension group was further divided into grade 1 group （140 mmHg≤SBP〈 160 mmHg and/or 90 mmHg≤DBP≤ 100 mmHg, n=45）, grade 2 group （160≤SBP 〈 180 mmHg and/or 100 mmHg≤ DBP≤ 110 mmHg, n=57） and grade 3 group （SBP≥ 180 mmHg and/or DBP≥ 110 mmHg, n=65） according to the BP grading standard in China Hypertension Prevention Guide. HRV data was recorded by using 24-hour Holter in all groups, and the difference in five time-domain indicators （SDNN, SDANN, HRV triangular index, RMSSD and PNN50） was analyzed and compared. Results All five time-domain indicators were lower in hypertension groups than those in control group （P〈0.05）, and were declined in turn in grade 1 group, grade 2 group and grade 3 group. SDNN, SDANN and HRV triangular index were compared between any two groups among control group, grade 1 group, grade 2 group and grade 3 group and showed statistical differences （all P〈0.05）. Conclusion There was dysfunction of autonomic nervous system in hypertensive patients, and as the rise of BP grades, the impaired autonomic nervous system will gradually worsen.