老年高血压患者心率变异性103例分析

目的　探讨老年高血压患者心率变异性的特点。方法　对 10 3例原发性高血压老年患者和 6 8例年龄相当的正常人进行 2 4小时心率变异性分析。结果　 (1)老年高血压患者时域分析和频域分析各项参数指标均减低。 (2 )老年高血压患者自主神经 2 4小时昼夜变化与正常人有差异 ,变频部分夜间明显减低 ,标志迷走神经活动失调 (P <0 .0 5 )。 (3)高血压伴糖尿病与无糖尿病患者的高频 /低频比值差异有显著性 (P <0 .0 5 )。 (4)高血压伴心肌缺血与无心肌缺血者的高频 /低频比值差异有显著性 (P <0 .0 5 )。结论　HRV分析是一种临床早期发现老年高血压患者心血管自主神经功能失调的好方法。

Clinical Analysis of Heart Rate Veriability in ElderlyHypertensive Patients

Objective To investigate the characteristics of heart rate variability (HRV) in elderly hypertensive patients.Methods Heart rate variability was evaluated in 103 elderly patients with hypertension and 68 healthy controls using 24-hour ambulatory ECG.Results (1) The standard deriation of 5-minute mean R-R intervals, mean of all 5-minute standard deriation of RRS, root-mean square of difference of successive RRS.Total frequency, low frequency and high frequency components of power specturm density in patients with elderly essential hypertension were reduced.(2)A significant different circardian rhythm in autonomic nervous activity between the hypertension and normal subjects with a markedly reduced high frequency in hypertensive subject at night (P<0.05),suggesting severe disturbance in parasympathetic activities.(3) The difference in high/low frequency ratio in hypertensive subject with and without diabetes mellitus is significant (P<0.05). (4) The difference in high/low frequency ratio in hypertensive subject with and without ischemic changes is significant (P<0.005). Conclusion HRV is a good method to clinically find disturbance in parasympathetic activities in elderly hypertensive patients.