缬沙坦对原发性高血压患者窦性心率震荡的影响

目的观察缬沙坦对原发性高血压患者窦性心率震荡的影响。方法对符合入选标准的75例原发性高血压患者,根据超声心动图结果分为左心室肥厚组35例,左心室正常组40例;健康对照组34例共3组;均行24h动态心电图监测。计算窦性心率震荡初始值（turbulence onset,TO）与震荡斜率值（turbulence slope,TS）,比较3组之间的差异。原发性高血压患者在常规治疗基础上加用缬沙坦治疗12周后,观察各组患者治疗前后心脏超声指标（LVMI）、心率震荡参数（TO、TS）等变化。结果左心室肥厚组、左心室正常组较对照组TO增大,TS降低（P〈0.05）;左心室肥厚组较左心室正常组TO增大,TS降低（P〈0.05）,左心室肥厚组LVMI均高于左室正常组与对照组（P〈0.05）,两组原发性高血压患者经缬沙坦治疗后的TO、LVMI降低,TS升高（P〈0.05）。结论原发性高血压患者存在自主神经损害,左室肥厚者损害更加明显,缬沙坦能有效改善原发性高血压患者自主神经功能的损伤及左心室肥厚。

Effects of Valsartan on heart rate turbulence of essential hypertensive patients

Objective To evaluate the effects of Valsartan on on heart rate turbulence of essential hypertension（EH）patients.Methods Seven-five hypertensive patients were divided into those with left ventricular hypertrophy（LVH）（n=35）and those without LVH（n=40）.The control group is normotensive participants（n=34）.In each group,24 hours dynamic electrocardiogram was recorded,turbulence onset（TO）and turbulence slope（TS）were calculated and the difference was compared.All hypertensive patients were treated by valsartan for 12 weeks.Cardiac ultrasonic indexes（LVMI）,HRT parameters（TS,TO）were observed.Results The difference in TO in three group was statistically significant（P〈0.05）.TO and LVMI was higher but TS was lawer in EH group with LVH,compared with EH group without LVH.（P〈0.05）.The levels of TO,LVMI lowered,TS increased in all hypertensive patients,compared with before treatment.Conclusion The dysfunction of autonomic nervous system has occurred in patients with EH,and the autonomic nerve function in EH patients with LVH is injured more seriously.In patients with EH Valsartan can improve the dysfunction of autonomic nervous system,and reverse left ventricular hypertrophy.