原发性高血压患者自主神经功能与血管损害相关性的观察

目的通过比较分析患者的心率变异性及血压变异性的关联，探讨原发性高血压患者自主神经功能与血管损害间的相关性。方法选取2012年1月至2014年1月我院收治的128例原发性高血压患者，根据脉搏波速率（PwV）将其分为正常组（〈9m／s）及受试组（≥9m／s），利用动态心电图监测及动态血压监测，观察血压变异性及心率变异性的相关指标，并使用SPSS19．0进行数据处理。结果受试组的每5rain心搏R—R间期平均值的标准差（SDANN）较正常组显著下降（P〈0．05）；受试组的收缩压、脉压均高于正常组（P〈0．05），但其舒张压与正常组比较无明显差异（P〉0．05）；且受试组的夜间收缩压下降率（SBPF）低于正常组（P〈0．05）；多元线性回归分析结果显示，24hPP、LF、LF／HF与PWV独立相关，其中24hPP、LF的相关性最强。结论心率变异性降低及血压变异性增强，导致原发性高血压患者的自主神经功能紊乱，提高交感神经兴奋性，是导致动脉硬化的独立危险因素。

Autonomic function in patients with essential hypertension observed correlation with vascular damage

Objective Through the analysis of heart rate variability and blood pressure variability of pa- tients with essential hypertension, we explored the correlation between autonomic nervous function and blood vessel impairment in the hypertension patients. Methods One hundred and twenty-eight patients with primary hypertension treated in our hospital from January 2012 to January 2014 were included in this study. The patients were divided into normal group （ 〈 9 m/s） and test group （≥ 9 m/s） according to pulse wave velocity （PWV）. Blood pressure was dynamically monitored using Holter monitor and ambula- tory blood pressure monitor, and related indicators of blood pressure variability and heart rate variability were observed and analyzed. SPSS 19.0 was used for statistical analysis. Results Compared with the normal group, the SDANN of test group was decreased significantly （P 〈 0.05） , the SBP and PP were higher, but the DBP showed no significant difference （P 〉 0.05）. The SBPF of test group was lower than that of the normal group （P 〈 0.05）. Multiple linear regression analysis showed that 24 h PP, LF, LF/ HF were independently associated with PWV, while the 24 h PP and LF had the strongest correlation Conclusions Reduction of heart rate variability and increase of blood pressure variability lead to auto- nomic nervous system dysfunction and increased sympathetic activity in patients with essential hyperten- sion, being an independent risk factor for atherosclerosis