原发性高血压伴急性脑梗死患者心率变异性与血压变异性分析

目的：探讨原发性高血压伴急性脑梗死患者的心率变异性（heart rate variability， HRV）和血压变异性（blood pressure variability，BPV）。方法收集原发性高血压合并急性脑梗死患者82例、单纯原发性高血压患者108例，进行动态心电图和动态血压同步测量，计算机自动计算 HRV 和 BPV 各指标。结果脑梗死组 HRV 各指标均低于单纯高血压组，且差异有统计学意义（P ＜0．05）；夜间血压下降率脑梗死组均低于单纯高血压组，BPV 各指标脑梗死组均高于单纯高血压组，其中夜间舒张压下降率、24 h 平均收缩压（24 h SBP）和24 h 收缩压变异系数（24 h SCV）两组差异有统计学意义（P ＜0．05）。结论与单纯原发性高血压患者相比，原发性高血压合并急性脑梗死患者自主神经功能受损明显。随访观察 HRV 和 BPV 指标的变化对高血压及高血压合并急性脑梗死患者的病情评估及改善预后有一定的临床意义。

Analysis of heart rate variability and blood pressure variability in patients with essential hy-pertension complicating acute cerebral infarction

Objective To investigate the heart rate variability(HRV)and blood pressure varia-bility(BPV)in patients with essential hypertension complicating acute cerebral infarction.Methods A total of 82 patients with essential hypertension complicating acute cerebral infarction and 108 patients with pure essential hypertension were enrolled in our study.Their ambulatory electrocardio-graphy and ambulatory blood pressure were measured synchronously.Indices of HRV and BPV were calculated by computer automatically.Results Compared with pure essential hypertension group, the value of each HRV index was lower in cerebral infarction group,with statistically significant difference(P <0.05).In cerebral infarction group,the descending rate of nocturnal blood pressure was lower than that in pure essential hypertension group while the value of each BPV index was high-er.And there were statistically significant differences(P <0.05)in the descending rate of nocturnal diastolic blood pressure,24-hour average systolic blood pressure(24 h SBP)and 24-hour systolic blood pressure coefficient of variation(24 h SCV)between the two groups.Conclusion The auto-nomic nervous function of the patients with essential hypertension complicating acute cerebral infarc-tion is significantly impaired if compared with the cases attacked by pure essential hypertension.It is clinically significant for evaluating severity and improving prognosis of hypertensives and those complicating acute cerebral infarction to make tracing observation on changes of HRV and BPV indi-ces.