CAJ | 학술논문

目的：探讨单纯收缩期高血压患者心率变异与动态血压变异的关系，观察原发性高血压患者自主神经功能损害与心室肥厚的相关性。方法选取57例单纯收缩期高血压患者为观察组（分为肥厚组和非肥厚组两个亚组），另选36例血压正常且无左室肥厚者为对照组。对两组同时进行24 h 动态心电图和24 h 动态血压监测，并记录其心率变异性（HRV）及血压变异性（BPV）的相关指标。结果发现观察组和对照组 HRV 和 BPV 呈相反的变化趋势，即HRV 时域指标 SDNN、rMSSD 以及 pNN50％均较对照组低，而24 h 收缩压标准差（24 h SSD）明显高于对照组，差异具有统计学意义（P 均＜0．01）。肥厚组各时段收缩压（SBP）数值均高于对照组，两组舒张压（DBP）比较差异无统计学意义。另外，肥厚组24 h 室性早搏发生率明显高于对照组，差异有统计学意义（P ＜0．01）。结论单纯收缩期高血压患者心率变异性和血压变异性的相关改变，提示自主神经功能损伤在高血压左室肥厚发展中发挥着重要作用。
목적：탐토단순수축기고혈압환자심솔변이여동태혈압변이적관계，관찰원발성고혈압환자자주신경공능손해여심실비후적상관성。방법선취57례단순수축기고혈압환자위관찰조（분위비후조화비비후조량개아조），령선36례혈압정상차무좌실비후자위대조조。대량조동시진행24 h 동태심전도화24 h 동태혈압감측，병기록기심솔변이성（HRV）급혈압변이성（BPV）적상관지표。결과발현관찰조화대조조 HRV 화 BPV 정상반적변화추세，즉HRV 시역지표 SDNN、rMSSD 이급 pNN50％균교대조조저，이24 h 수축압표준차（24 h SSD）명현고우대조조，차이구유통계학의의（P 균＜0．01）。비후조각시단수축압（SBP）수치균고우대조조，량조서장압（DBP）비교차이무통계학의의。령외，비후조24 h 실성조박발생솔명현고우대조조，차이유통계학의의（P ＜0．01）。결론단순수축기고혈압환자심솔변이성화혈압변이성적상관개변，제시자주신경공능손상재고혈압좌실비후발전중발휘착중요작용。
Objective To investigate the relationship between heart rate variability(HRV)and ambulatory blood pressure variability(BPV)in patients with isolated systolic hypertension(ISH), and to observe the relevance of autonomic nerve functional lesion to ventricular hypertrophy for es-sental hypertensives.Methods Fifty-seven patients with ISH were enrolled as observation group (including two subgroups:hypertrophy group and non-hypertrophy group)while another 36 individu-als with normal blood pressure and without left ventricular hypertrophy as control group.The two groups underwent 24-hour ambulatory electrocardiography(Holter)and 24-hour ambulatory blood pressure monitoring(ABPM)simultaneously,with related HRV and BPV indices recorded.Results The change trends of HRV and BPV were found to be opposite between observation group and control group.That was to say,HRV time domain indices of SDNN,rMSSD and pNN50% in obser-vation group were significantly lower than those of control group while 24 h SSD was significantly higher,both with statistically significant differences (P <0.01 ).Compared with that of control group,SBP value of hypertrophy group was higher in each time period,while there was no statisti-cally significant difference between DBP value of the two groups.In addition,the incidence of 24-hour ventricular premature beat among hypertrophy group was higher than that in control group,with statistically significant difference(P <0.01 ).Conclusion The relevant changes of HRV and BPV in patients with isolated systolic hypertension indicate the important role autonomic nerve functional <br> lesion plays in the development of hypertensive left ventricular hypertrophy.