比索洛尔对原发性高血压左室肥厚与心率变异性及血压昼夜节律异常的影响

   摘要  目的 观察比索洛尔对原发性高血压(EH)左室肥厚(LVH)与心率变异性(HRV)及血压昼夜节律异常的影响。方法 50例EH伴LVH患者治疗前行24小时动态血压、24小时动态心电图及超声心动图检查,并于治疗后8周进行复查比较,并比较EH患者HRV指标与国人正常参考值之间的差异。结果 血压昼夜节律消失组33例,血压昼夜节律正常组17例。血压昼夜节律消失组24h收缩压(24hSBP)、夜间血压(nBP)、血压负荷均高于血压昼夜节律正常组。EH患者的24hHRV指标均显著低于正常参考值。经过8周的比索洛尔治疗,比索洛尔对EH患者能够显著降低血压。血压昼夜节律消失组昼夜节律、24hHRV、室间隔厚度(IVST)、左室舒张末期厚度(LVPWT)、左室重量(LVMI)指标均有明显改善,血压昼夜节律正常组也有改善。结论 高血压LVH患者血压昼夜节律消失多见,24hHRV显著降低,比索洛尔在降压的同时具有改善血压昼夜节律、HRV和LVH的作用。    Effects of Bisoprolol on essential hypertensive left ventricular hypertrophy and heart rate variability with abnormal circadian rhythm of blood pressure1 WU Qizhi. Department of cardiology HuLi Hospital Xiamen Fujian 361006 ChinaAbstract Objective To study the Effects of Bisoprolol on essential hypertensive (EH) left ventricular hypertrophy (LVH) and heart rate variability (HRV) with abnormal circadian rhythm of blood pressure. Method 50 patients of EH with LVH were selected for 24h ABPM、Holter and UCG before and after Bisoprolol taken.Result Abnormal circadian rhythms were found in 33 patients normal circadian rhythms in 17 patients. 24hSBP、nBP、and BP load were higher in abnormal circadian rhythms group. 24h HRV parameters were significantly lower than normal field LF higher than normal field. 8 weeks after bisoprolol therapy blood pressure was reduced significantly circadian rhythm of blood pressure、24h HRV、IVST、LVPWT and LVMI were improved distinctly in abnormal circadian rhythms group. These were also improved in the patients with normal circadian rhythm.Conclusions Abnormal circadian rhythm were discovered frequently and HRV was decreased in the patients with EH and LVH. Bood pressure are decreased significantly abnormal circadian rhythms、HRV and LVH are improved by the treatment of bisopolol in patients with EH.Key words Essential hypertension Left ventricular hypertrophy Hypertension circadian rhythm Heart rate variability Bisoprolol   高血压(EH)左心室肥厚(LVH)是以左心室结构改变,左心室功能减退为其特征,是独立于高血压之外的心血管病主要的危险因子[1],且常伴有心率变异性(HRV)下降[2]及血压昼夜节律消失[3]。本研究旨在分析比索洛尔对原发性高血压左室肥厚,心率变异性及血压昼夜节律的影响 
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