CAJ | 학술논문

目的：探讨高血压前期（ prehypertension，PHT）与自主神经功能改变的关系，为预防高血压发生提供依据。方法根据纳入、排除标准，选取2013年1月—2014年3月来河南大学淮河医院就诊的患者520例。根据《中国高血压指南》（2010）中PHT的诊断标准，将520例患者分为对照组（非PHT组）和研究组（ PHT组）。其中，对照组200例，研究组320例，根据收缩压和舒张压升高情况，将研究组分为3个亚组。应用美国DMS公司12.0TOP版动态心电图分析软件，监测心率减速力（ deceleration capacity of rate，DC）和心率变异性（ heart rate variability，HRV）两个自主神经功能指标，定性、定量分析两组自主神经功能改变情况。结果研究组DC低于对照组，差异有统计学意义（P<0.05）；HRV的三个指标，总体标准差（SDNN）、差值均方根（RMMSD）、超过50 ms百分比（PNN50），研究组均较对照组低，差异有统计学意义（ P<0.05）；研究组3个亚组间的DC、HRV比较，差异无统计学意义（ P>0.05）。结论 PHT的发生可能与自主神经功能失调有关。DC和HRV可以定性、定量了解PHT人群自主神经功能改变情况，及时调整自主神经功能有助于预防高血压的发生。
목적：탐토고혈압전기（ prehypertension，PHT）여자주신경공능개변적관계，위예방고혈압발생제공의거。방법근거납입、배제표준，선취2013년1월—2014년3월래하남대학회하의원취진적환자520례。근거《중국고혈압지남》（2010）중PHT적진단표준，장520례환자분위대조조（비PHT조）화연구조（ PHT조）。기중，대조조200례，연구조320례，근거수축압화서장압승고정황，장연구조분위3개아조。응용미국DMS공사12.0TOP판동태심전도분석연건，감측심솔감속력（ deceleration capacity of rate，DC）화심솔변이성（ heart rate variability，HRV）량개자주신경공능지표，정성、정량분석량조자주신경공능개변정황。결과연구조DC저우대조조，차이유통계학의의（P<0.05）；HRV적삼개지표，총체표준차（SDNN）、차치균방근（RMMSD）、초과50 ms백분비（PNN50），연구조균교대조조저，차이유통계학의의（ P<0.05）；연구조3개아조간적DC、HRV비교，차이무통계학의의（ P>0.05）。결론 PHT적발생가능여자주신경공능실조유관。DC화HRV가이정성、정량료해PHT인군자주신경공능개변정황，급시조정자주신경공능유조우예방고혈압적발생。
Objective To explore the relationship between prehypertension and the changes of autonomic nervous sys-tem function,and to provide evidence for the prevention of hypertension. Methods By random sampling method,520 patients visiting in Huaihe Hospital of Henan University from January 2013 to March 2014 were selected and divided into control group (non PHT group,n=200)and research group(PHT group,n=320)according to the diagnostic criteria for PHT mentioned in the" Chinese Hypertension Guide",the latter being subdivided into three groups according to the rise of systolic and diastolic blood pressure. Two autonomic nervous function indexes,the deceleration capacity of rate( deceleration capacity of rate,DC) and heart rate variability( heart rate variability,HRV)were detected to compare the two groups' autonomic function change qualitatively and quantitatively,by DMS 12. 0 TOP version,a kind of dynamic ECG analysis software. Results DC in the study-group was lower than the control group,the difference was statistically significant(P<0. 05). Overall standard deviation,root mean square,difference over 50 ms percentage( three indexes reflecting HRV)in the study group werelower than the control group,the difference was statistically significant(P<0. 05). DC and HRV were no significant difference among the three study subgroups(P>0. 05). Conclusion The occurrence of PHT may be associated with autonomic nervous dysautonomia. DC and HRV can reflect the changes of autonomic nervous system function of PHT peoplequalitatively and quantitatively,thus help adjust the autonomic nerve function to prevent theoccurrence of hypertension.