CAJ | 학술논문

目的：探讨厄贝沙坦时辰化用药对老年晨峰高血压患者心率变异性（ HRV）及QT离散度（ QTd）的影响。方法62例合并血压晨峰现象的老年高血压患者，睡前口服厄贝沙坦，治疗前及治疗6个月后分别测定患者HRV及QTd并分析比较。结果治疗后24 h平均收缩压、24 h平均舒张压、夜间平均收缩压、夜间平均舒张压及血压晨峰均较治疗前明显降低，差异均有统计学意义（P＜0.05）；治疗后相邻正常RR间期标准差（SDNN）、相邻正常RR间期差值的方差（rMSSD）、相邻正常RR间期差值大于50 ms的窦性心律占心搏总数的百分比（PNN50）、高频功率（HF）明显增加（P＜0.05），而低频功率（LF）则明显降低（ P ＜0.05）；QTd较前明显下降，差异均有统计学意义（ P＜0.05）。结论厄贝沙坦时辰化用药降低老年高血压病患者血压晨峰对HRV有显著的改善作用，并可有效降低QTd。
목적：탐토액패사탄시신화용약대노년신봉고혈압환자심솔변이성（ HRV）급QT리산도（ QTd）적영향。방법62례합병혈압신봉현상적노년고혈압환자，수전구복액패사탄，치료전급치료6개월후분별측정환자HRV급QTd병분석비교。결과치료후24 h평균수축압、24 h평균서장압、야간평균수축압、야간평균서장압급혈압신봉균교치료전명현강저，차이균유통계학의의（P＜0.05）；치료후상린정상RR간기표준차（SDNN）、상린정상RR간기차치적방차（rMSSD）、상린정상RR간기차치대우50 ms적두성심률점심박총수적백분비（PNN50）、고빈공솔（HF）명현증가（P＜0.05），이저빈공솔（LF）칙명현강저（ P ＜0.05）；QTd교전명현하강，차이균유통계학의의（ P＜0.05）。결론액패사탄시신화용약강저노년고혈압병환자혈압신봉대HRV유현저적개선작용，병가유효강저QTd。
Objective To investigate the influence of irbesartan chronotherapy on morning blood pressure surge in elderly hy -pertensive patients with heart rate variability ( HRV) and QT dispersion ( QTd) .Methods Sixty-two patients with morning blood pres-sure surge took irbesartan before bedtime .The HRV and QTd of the patients were observed and analyzed before and after 6 months of treatment .Results Compared with treatment before ,ambulatory blood pressure indexes significantly improved and morning blood pres-sure surge significantly decreased after treatment ( all P <0.05 ) .After treatment ,the adjacent normal RR interval standard difference (SDNN),the variance of adjacent normal RR interval difference (rMSSD),the total percentage (PNN50) of rMSSD that was greater than 50 ms in sinus rhythm beats,and high frequency power (HF) were increased significantly (P<0.05).The low frequency power (LF) was decreased significantly (P<0.05).The QTd was decreased significantly after treatment (P<0.01).Conclusion Irbesar-tan chronotherapy can reduce the degree of morning blood pressure surge in elderly patients with hypertension .This plays a significant role in the improvement of HRV and reduction of QTd .