Ohisa Noriko, Imai Yutaka, Hashimoto Junichiro, Yoshida Katsumi, Kaku Mitsuo
Department of Clinical Laboratory, Tohoku University Hospital, Sendai 980-8574.
Rinsho Byori. 2002 Sep;50(9):899-905.
Autonomic nervous function was evaluated by means of power spectral analysis of heart rate variability in hospitalized patients with different circadian blood pressure(BP) variation, i.e., dipper(n = 33), non-dipper(n = 37), extreme dipper(n = 26) and riser(n = 20). Ambulatory BP monitoring was performed by A & D TM2425 based on a cuff-oscillometric method. Circadian BP variation was defined in these subjects. The non-dipper, extreme dipper and riser subjects were defined as those whose nocturnal decrease in systolic BP was less than 10%, more than 20% and elevation of BP, as compared to the daytime BP, respectively. Power spectral analysis of hourly R-R intervals for 24 hours was done to obtain the low frequency power(LF, 0.04 to 0.15 Hz) and high frequency power(HF, 0.15 to 0.40 Hz). LF/HF ratio was considered to be an index of sympathetic nervous activity, and HF parasympathetic nervous activity, respectively. LF/HF was significantly lower in both riser and non-dipper than that in dipper subjects throughout the day. In non-dipper day-night difference of HF was smaller than in dipper and extreme dipper groups. These findings indicated that riser and non-dipper hypertensives were characterized by decreased physiological circadian fluctuation of autonomic functions when compared to dipper subjects. The circadian variation of BP may be mediated at least in part by circadian variation of autonomic nervous system activity.
通过对不同昼夜血压(BP)变化的住院患者进行心率变异性功率谱分析,评估自主神经功能,即勺型血压者(n = 33)、非勺型血压者(n = 37)、超勺型血压者(n = 26)和反勺型血压者(n = 20)。采用A&D TM2425基于袖带振荡法进行动态血压监测。定义了这些受试者的昼夜血压变化。非勺型、超勺型和反勺型受试者分别定义为夜间收缩压下降小于10%、大于20%以及与白天血压相比血压升高者。对24小时每小时的R-R间期进行功率谱分析,以获得低频功率(LF,0.04至0.15Hz)和高频功率(HF,0.15至0.40Hz)。LF/HF比值分别被视为交感神经活动和副交感神经活动的指标。全天反勺型和非勺型受试者的LF/HF均显著低于勺型受试者。非勺型受试者HF的昼夜差异小于勺型和超勺型组。这些发现表明,与勺型受试者相比,反勺型和非勺型高血压患者的自主神经功能生理性昼夜波动降低。血压的昼夜变化可能至少部分由自主神经系统活动的昼夜变化介导。