氯沙坦钾对原发性高血压病合并2型糖尿病患者心率变异性的影响

目的探讨原发性高血压病合并2型糖尿病患者的心率变异性(HRV)特点及氯沙坦钾对其的影响。方法 52例原发性高血压病合并2型尿病患者,口服氯沙坦钾(50mg/d)12周前后HRV变化并与健康对照组(40名)比较。结果原发性高血压病合并2型糖尿病患者的HRV治疗前明显低于健康对照组,给予氯沙坦钾12周干预治疗后HRV值明显上升。低频功率与高频功率比值(LF/HF)显著降低(P<0.05)。结论原发性高血压病合并2型糖尿病患者自主神经活动明显受损,其迷走神经张力降低,交感神经张力相对增高,发生心源性猝死的危险性明显增加。氯沙坦钾能有效提高心脏迷走神经张力,降低交感神经张力,有可能减少心律失常性死亡。

Effects of Losartan on heart rate variability in hypertensive patients with type 2 diabetes mellitus

Objective To investigate the effects of Losartan on heart rate variability(HRV)in patients with esse-ntial hypertension(EH)and type 2 diabetes mellitus(DM).Methods Fifty-two patients with EH and DM took Losartan(50 mg/d)orally for 12 weeks.The changes of HRV mellitue were analyzed and compared with that of 40 healthy controls.Results The HRV of patients with EH and DM was lower than that of normal controls.After Losartan treatment,the SDNN,RMSSD,PNN 50 and HF increased but LF/HF decreased markedly(P<0.05).Conclusion Losartan can increase cardiac vagal activity and decrease sympathetic activity in patients with EH and DM,which suggests that Losartan may reduce the arrhythmic mortality.