摘要
目的了解冠状动脉粥样硬化性心脏病(冠心病)患者心率变异性(HRV)特点。方法入选156例冠心病患者及128例正常体检人员,进行24小时动态心电图监测。冠心病组通过彩色多普勒超声显像仪测量心功能(LVEF)并分组为射血分数正常组(LVEF≥50%)和射血分数下降组(LVEF<50%),同时对冠心病组进行不同年龄段的分组,计算各组的心率变异性参数:NN间期标准差(SDNN)、NN间期平均值的标准差(SDANN)、相邻NN间期差的均方根(RMSSD)、相邻NN间期的差值超过50 ms的心搏数占NN间期总心搏数的百分比(pNN50)、5分钟总功率(TP)、低频功率(LF)、高频功率(HF),通过组间比较分析,分析比较各组间HRV参数的特点。结果与正常对照组比较,冠心病组患者SDNN(96.2±28.8 ms vs.138.1±27.7 ms)、SDANN(79.4±27.1 ms vs.130.4±28.2ms)、RMSSD(24.3±9.8 ms vs.31.2±9.3 ms)、pNN50(8.5±3.2 ms vs.12.3±3.9 ms)及HF(233.6±95.5 ms2 vs.292.3±100.2 ms2)均明显下降,差异均有统计学意义(P均<0.05)。冠心病患者中,射血分数下降组患者SDNN、SDANN、RMSSD、pNN50、TP、HF均较射血分数正常组患者降低,差异均有统计学意义(P均<0.05),在不同年龄段冠心病组间SDNN、TP以及RMSSD、pNN50、LF、HF水平比较,差异无统计学意义(P>0.05);35～45岁组SDANN高于55～65岁组,差异有统计学意义(P<0.05)。结论冠心病患者心率变异性降低,射血分数下降会进一步加重自主神经的损害。
Objective To understand the features of heart rate variability （HRV） in the patients with coronary heart disease （CHD）. Methods CHD patients （CHD group, n=156） and normal medical examiners （control group, n=128） were chosen and given 24-h ambulatory blood pressure monitoring （ABPM）. CHD group was given color Doppler ultrasonic imaging apparatus for measuring left ventricular ejection fraction （LVEF） and then divided into normal LVEF group （LVEF≥50%） and lower LVEF group （LVEF〈50%）, and meanwhile CHD group was divided into groups according to age. The parameters of HRV were calculated including SDNN, SDANN, RMSSD, pNN50, TP, LF and HF, and the features of these parameters were compared and analyzed among all groups. Results SDNN （96.2±28.8 ms vs. 138.1±27.7 ms）, SDANN （79.4±27.1 ms vs. 130.4±28.2 ms）, RMSSD （24.3 ms±9.8 vs. 31.2 ±9.3 ms）, pNN50 （8.5±3.2 ms vs. 12.3±3.9 ms） and HF （233.6±95.5 ms2 vs. 292.3±100.2 ms2） all decreased significantly in CHD group compared with control group （all P〈0.05）. SDNN, SDANN, RMSSD, pNN50, TP and HF decreased in lower LVEF group compared with normal LVEF group （all P〈0.05）, while the comparison in SDNN, TP, RMSSD, pNN50, LF and HF showed no statistical difference among different age groups （P〉0.05）. SDANN was higher in 35-45 year-old group than that in 55-65 year-old group （P〈0.05）. Conclusion In CHD patients, HRV decreases, and the decrease of LVEF will further exacerbate the damage of autonomic nervous function.
出处
《中国循证心血管医学杂志》
2014年第3期302-305,共4页
Chinese Journal of Evidence-Based Cardiovascular Medicine
关键词
心率变异性
冠心病
左室射血分数
Heart rate variability
Coronary heart disease
Left ventricular ejection fraction
