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目的探讨高血压病患者两种不同血压昼夜模式对心率变异性(HRV)指标的影响及其临床意义。方法选择符合WHO诊断标准的高血压病患者187例,根据动态血压监测结果将其分为血压昼夜节律正常(杓型)和血压昼夜节律消失(非杓型)两组,并将他们同期所做的动态心电图HRV结果进行对比分析后,获取两组高血压患者自主神经系统活动反应的实验数据。结果与血压昼夜节律正常组(杓型组)相比,血压昼夜节律消失组(非杓型组)三个时段多项心率变异性指标均有明显下降(P<0.01)。结论高血压病患者两种不同血压昼夜模式对HRV指标的影响有明显差别,血压昼夜节律消失的高血压病患者自主神经功能受损更加严重,可能更易引起心、脑、肾等靶器官损害。
Objective To investigate the effect of two different blood pressure diurnal patterns on heart rate variability (HRV) in patients with essential hypertension and its clinical significance. Methods A total of 187 hypertensive patients were selected according to WHO diagnostic criteria. According to the results of ambulatory blood pressure monitoring, they were divided into two groups: normal circadian rhythm of blood pressure (dipper type) and disappearance of circadian rhythm of blood pressure (non-dipper type) Of the dynamic electrocardiogram HRV results were analyzed and compared to obtain two sets of experimental data of autonomic nervous system activity in patients with hypertension. Results Compared with the normal circadian rhythm group (dipper group), the multiple indices of heart rate variability in the diurnal rhythm disappearance group (non-dipper group) were significantly decreased (P <0.01). Conclusion The two different blood pressure diurnal patterns of hypertension in patients with hypertension have significant differences on HRV indexes. The patients with hypertension with abnormal circadian rhythm of blood pressure suffer more severe autonomic dysfunction and may cause more damage to target organs such as heart, brain and kidney.