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目的:观察原发性高血压(EH)患者的血压变异性(blood pressure variability,BPV)与心律失常的相互关系。方法:根据24h收缩压BPV的总变异系数(coefficient variation,CV)将67例EH患者分为2组:高CV(CV>10.62%)组和低CV(CV≤10.62%)组。应用24h动态血压和24h动态心电图监测观察并比较2组患者的动态BPV与心律失常的相关关系。结果:除夜间舒张压外,2组其他时段动态血压水平及昼夜间QTc值差异均无统计学意义。高CV组除夜间房性期前收缩外,各时段期前收缩的每小时发生次数和复杂室性心律失常的发生率及收缩压BPV(BPVS)和舒张压BPV(BPVD)均明显高于低CV组,且期前收缩的发生次数与BPVS值的大小呈正相关(r=0.7993,P<0.05)。组内比较低CV组昼夜间室性期前收缩每小时的发生次数差异有统计学意义,且具昼夜节律性;而高CV组内差异无统计学意义,且昼夜节律性消失。结论:EH患者心律失常的发生与BPV相关,且昼夜节律性易消失。
Objective: To observe the relationship between blood pressure variability (BPV) and arrhythmia in patients with essential hypertension (EH). Methods: 67 EH patients were divided into two groups according to the coefficient of variation (CV) of 24h systolic BPV: high CV (CV> 10.62%) and low CV (CV≤10.62%). 24h dynamic blood pressure and 24h Holter monitoring were used to observe and compare the dynamic BPV and arrhythmia in the two groups. Results: In addition to nocturnal diastolic pressure, there were no significant differences in ambulatory blood pressure levels and QTc values at other times between the two groups. Except nocturnal atrial contraction in high CV group, the incidence of systolic hourly and complex ventricular arrhythmia and BPVS and BPVD of systolic BP were significantly higher than those in low CV CV group, and the number of premature contractions was positively correlated with the size of BPVS (r = 0.7993, P <0.05). There was significant difference in the number of occurrence of ventricular premature contractions per hour between CV group and CV group, while the circadian rhythm was not significant in CV group, and circadian rhythms disappeared. Conclusion: The incidence of arrhythmia in patients with EH is associated with BPV, and the circadian rhythm tends to disappear.