摘要
目的探讨心力衰竭患者心率震荡（HRT）的变化及其与心力衰竭严重程度的相关性。方法对心力衰竭患者（83例）及对照组患者（36例）进行24h动态心电图检查，分别计算震荡初始（TO）和震荡斜率（TS），比较2组患者TO及TS均值；并比较不同心力衰竭严重程度及心功能分级下的HRT。结果心力衰竭组的TO值高于对照组[（-0．31±-0．17）％与（-1．63±-0．23）％，P〈0．01）]，髑值低于对照组[（2．24±1．42）ms／R-R与（8．73±3．68）ms／R-R，P〈0．001）]；在心力衰竭组，存在肢端水肿、颈静脉怒张、肺淤血、心胸比增大、左心室射血分数降低、心腔扩大、心率增快和心率变异异常的患者，其TO值明显升高，偈值明显降低（P均〈0．05）；按照纽约心脏病学会心功能分级标准，分级水平越高，TO值越高、而TS值越低。结论慢性心力衰竭患者心率震荡现象明显受损；心率震荡的减弱与心力衰竭严重程度密切相关。
Objective To study the changes of heart rate turbulence （HRT） in patients with chronic heart failure. Methods 24 h Holter ECG recordings were examined in 83 patients with heart failure（HF） and 36 in the comparison group. Turbulence onset （TO） and turbulence slope （TS） were calculated from Holter recordings. The mean value of TO, TS between the two groups were compared; TO and TS in defferent degree of severity of HF, HRT of different New York Heart Association Classification （NYHA）were also compared. Results TO is significantly higher in the HF group than in the comparison group [ （ -0.31 ±-0. 17）% vs （ -1.63 ± -0.23 ）%, P 〈 0.01 ） ], and TS in the HF group is significantly lower [ （2.24 ± 1.42） msZR-R vs （ 8.73 ± 3.68 ） ms/R-R, P 〈 0.01 ） ]. In the HF group, TO is higher and TS is lower in patients with the third tone, peripheral edemas ,jugular distension, pulmonary congestion, cardiothoracic ratio 〉 0.55, LVEF 〈 45%, LVESD 〉 46 mm, LVEDD 〉 60 ram, HR 〉 80 bpm and HRV 〈 70 ms （P 〈 0.05 ）. The difference of HRT for patients in different NYHA classification is significant. Conclusion The existence of heart rate turbulence is significantly impaired in patients with chronic heart failure,which reflects the severity of HF well.
出处
《中国综合临床》
2009年第1期31-33,共3页
Clinical Medicine of China
关键词
心率震荡
心力衰竭
室性期前收缩
Heart rate turbulence
Heart failure
Ventricular premature complex
