高血压患者血压、心率变异性与颈动脉内中膜厚度的关系

摘要

目的 探讨高血压患者血压、心率变异性与颈动脉内中膜厚度之间的关系.方法 选择高血压患者86例及健康人42例进行动态血压、动态心电图监测及颈动脉内中膜厚度测量.结果 2个高血压组与对照组比较,其不同时段平均收缩压、24h收缩压标准差及日间收缩压标准差差异均有统计学意义;同时颈动脉内中膜增厚组(intima-media thickness,IMT)不同时段平均收缩压、24h收缩压标准差及日间收缩压标准差显著高于单纯高血压组(pure hypertension group,PHt)及对照组.2个高血压组与对照组比较,心率变异性降低;IMT组全部正常性R-R间期的标准差(standard deviation of the normal-to-normal interval,SDNN)减低程度明显高于PHt 组及对照组.IMT组血压、心率变异性主要指标相关分析发现,24h收缩压标准差、日间收缩压标准差与SDNN呈负相关,而与低频功率/高频功率呈正相关.结论 高血压患者存在机体自主神经功能受损,而合并有颈动脉硬化者可加重自主神经功能紊乱.%Objective To investigate the relationships of blood pressure variability( BPV ), heart rate variability ( HRV ) and carotid intima - media thickness in patients with hypertension. Methods In 86 patients with hypertension and 42 healthy people, ambulatory blood pressure monitoring, dynamic electrocardiogram and carotid intima - media thickness were recorded and analyzed. Results The mean systolic blood pressure of different time, 24 hour systolic blood pressure standard deviation ( 24hSBP -SD ) and daytime systolic blood pressure standard deviation ( dSBP - SD ) were of significant difference between the two hypertension groups and control group; at the same time, Mean systolic blood pressure of different time, 24 hSBP - SD and dSBP - SD of the intima - media thickening group ( IMT ) were significantly higher than those of pure hypertension group ( PHt ) and the control group. Compared with control group, heart rate variability of the two hypertension groups decreased; moreover, standard deviation of the normal - to - normal interval ( SDNN ) of group IMT reduced significantly higher than those of group PHt and control group. The correlation analysis between BPV and HRV main indexes in group IMTfound that 24 hSBP - SD, dSBP - SD were negatively correlated with SDNN, and positively correlated with LF/HF. Conclusion Patients with hypertension have autonomic nervous system function impairment, while the autonomic nervous disorders are aggravated with carotid artery sclerosis.