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目的观察高血压患者的窦性心率震荡(HRT)现象及坎地沙坦对其干预的影响。方法对符合入选标准的96例原发性高血压患者,根据超声心动图结果分为左心室肥厚组35例,左心室正常组40例,健康对照组40例共3组;均行24h动态心电图监测。原发性高血压患者(治疗组)治疗(8～16mg坎地沙坦,1次/d)前后及健康对照者(对照组)的HRT指标的变化。结果左心室肥厚组、左心室正常组较对照组TO增大,TS降低(P<0.01);左心室肥厚组较左心室正常组TO增大,TS降低(P<0.01),左心室肥厚组LVMI均高于左室正常组与对照组(P<0.01),两组原发性高血压患者经坎地沙坦治疗后的TO、LVMI降低,TS升高(P<0.05)。结论原发性高血压患者存在自主神经损害,左室肥厚者损害更加明显,坎地沙坦可有效降压,并可改善高血压患者的自主神经功能及左心室肥厚。
Objective To observe the sinus rhythm of heart rate turbulence (HRT) in patients with hypertension and candesartan intervention. Methods According to the results of echocardiography, 96 patients with essential hypertension who met the inclusion criteria were divided into three groups: left ventricular hypertrophy group (n = 35), left ventricular normal group (n = 40) and healthy control group (n = 40) monitor. The changes of HRT index in patients with essential hypertension (treatment group) before and after treatment (8-16 mg of candesartan, once a day) and healthy controls (control group). Results In left ventricular hypertrophy group and normal left ventricle group, TO increased and TS decreased (P <0.01); left ventricular hypertrophy group had higher TO and lower TS (P <0.01), left ventricular hypertrophy group (P <0.01). LV, LVMI and TS of candesartan in patients with essential hypertension after candesartan treatment were significantly higher than those in control subjects (P <0.01). Conclusions Autonomic nerve damage exists in patients with essential hypertension and the damage is more obvious in patients with left ventricular hypertrophy. Candesartan is effective in lowering blood pressure and improving autonomic function and left ventricular hypertrophy in hypertensive patients.