摘要
为通过了解心肌缺血时心率变异性(HRV)的改变,探讨冠心病自主神经失衡的状况,前瞻、顺序地观察静息心电图呈典型心肌缺血的冠心病患者21例、心电图正常的冠心病患者19例和健康人22例HRV时域、频域指标。结果显示:与健康人比较,心电图心肌缺血组HRV降低非常显著(P<0.01)的指标为SDNN(113±12.2对85±22.9)、SDANN(100±14.5对74±21.8)、TP(2170±794对1366±859)、VLF(1422±473对924±568);显著降低(P<0.05)的指标为SDNN_(Index)(48±11.1对39±12.1)、LF(441±258对279±193)、HF(266±171对142±157)。与健康人比较,心电图正常组LF/HF增大非常显著(1.9±1.1对3.3±1.7,P<0.01).其余各项指标降低差异无显著意义(P>0.05)。与心电图正常患者比较,心电图缺血患者SDNN、SDANN、LF进一步降低(107±30.8对85±22.9、96±29.0对74±21.8、496±383对279±193,P<0.05)。提示:冠心病患者HRV多项指标普遍降低而LF/HF增大,表明交感、迷走神经张力不均衡地降低而交感神经相对兴奋。冠心病患者HRV降低可能与其心肌缺血的程度有关。
To understand relationship between myocardial ischemia and heart rate variability (HRV) ,and study changes in autonomic nervous function in patients with coronary artery disease, authors investigated HRV in 21 patients with typical myocardial ischemia, 19 patients without typical myocardial ischemia in rest electrocardiogram (ECG), and 22 healthy volunteers. Results showed: Compared with healthy volunteer group,HRV in diseased group,decreased very significantly (P<0.01) with indices of SDNN(113±12.2 vs.85 ± 22.9), SDANN(100±14.5 vs.74 ± 21.8), TP(2170±794 vs. 1366± 859) ,and VIF (1422± 473 vs. 924 ± 568),following indice showed significantly decrease (P < 0.05): SDNN Index (48±11.1 vs. 39±12.1), LF(441±258 vs.279±193), and HF(266±171 vs. 142±157) in patients with typical myocardial ischemia.Compared with healthy volunteers , LF/ HF ratio increased sharply (1.9±1.1 vs.3.3±1.7, P < 0.01)and other components of HRV were tended to decerase but no significant change in patients without typical my-ocardial ischemia( P > 0.05) . Compared with patients who had normal electrocardiogram, SDNN, SDANN, LF demonstrated decrease significant(107±30.8 vs.85±22.9, 96±29.0 vs.74±21.8, 496±383 vs.279±193), in patients with typical myocardial ischemia (P < 0.05) .Conclusion: LF/HF ratio increase and decrease of other components of HRV reveal that autonomic nervous activitiesare reduced and sympathetic tone is relatively higher in patients withCAD.
出处
《心电学杂志》
1998年第3期137-138,152,共3页
Journal of Electrocardiology(China)
关键词
冠心病
心率变异性
心肌缺血
心电图
Coronary artery disease Heart rate variability Myocardial ischemia Electrocardiogram