慢性失眠对老年糖尿病患者静息心率及心率变异性的影响

目的探讨慢性失眠对老年糖尿病患者静息心率(RHR)及心率变异性(HRV)的影响。方法入选老年患者236例,分为健康对照组62例,单纯糖尿病组64例,糖尿病合并失眠组110例,其中糖尿病合并失眠组按失眠病程分为<5年组(40例),5⁹年组(38例)和≥10年组(32例)。所有患者行常规心电图及24 h心电图检查,并对RHR,HRV时域指标窦性R-R间标准差(SDNN)、窦性R-R间期标准差(SDANN)、窦性R-R间期标准差均值(SDNN index)、窦性R-R间期差值>50 ms(r MSSD)和R-R连质差异均值的平方根(PNN50),频域指标低频(LF)、高频(HF)及LF/FH进行对比分析。结果与健康对照组相比,单纯糖尿病组和糖尿病合并失眠组HRV各时域指标及频域指标LF、HF降低,RHR及LF/HF增高(P<0.05)。与单纯糖尿病组相比,糖尿病合并失眠组HRV各时域指标及频域指标LF、HF降低明显,LF/HF增高明显(P<0.05)。糖尿病合并失眠组中失眠病程59年组(38例)和≥10年组(32例)。所有患者行常规心电图及24 h心电图检查,并对RHR,HRV时域指标窦性R-R间标准差(SDNN)、窦性R-R间期标准差(SDANN)、窦性R-R间期标准差均值(SDNN index)、窦性R-R间期差值>50 ms(r MSSD)和R-R连质差异均值的平方根(PNN50),频域指标低频(LF)、高频(HF)及LF/FH进行对比分析。结果与健康对照组相比,单纯糖尿病组和糖尿病合并失眠组HRV各时域指标及频域指标LF、HF降低,RHR及LF/HF增高(P<0.05)。与单纯糖尿病组相比,糖尿病合并失眠组HRV各时域指标及频域指标LF、HF降低明显,LF/HF增高明显(P<0.05)。糖尿病合并失眠组中失眠病程5⁹年组和≥10年组的HRV各时域指标及频域指标LF、HF降低,RHR及LF/HF增高(P<0.05);失眠病程≥10年组的HRV各时域指标及频域指标LF、HF较59年组和≥10年组的HRV各时域指标及频域指标LF、HF降低,RHR及LF/HF增高(P<0.05);失眠病程≥10年组的HRV各时域指标及频域指标LF、HF较5⁹年组进一步降低,RHR及LF/HF进一步增高(P<0.05)。结论慢性失眠可加重老年糖尿病患者自主神经功能紊乱,其中失眠病程越长,糖尿病患者自主神经功能紊乱程度更明显。     

不同血压分级的原发性高血压患者心率变异性分析

目的 探讨不同高血压分级患者的心率变异性（HRV）特征,了解高血压对自主神经功能的影响.方法 纳入2011年6月-2012年6月我院心内科高血压患者（n=167）及健康对照组（n=50）,进一步根据〈中国高血压防治指南〉血压分级标准将高血压组分为：高血压1级组[140 mmHg≤收缩压（SBP）＜160 mmHg和/或90 mmHg≤舒张压（DBP）≤100 mmHg,n=45]、高血压2级组（160≤SBP＜180 mmHg和/或100 mmHg≤DBP≤110 mmHg,n=57）、高血压3级组（SBP≥180 mmHg和/或DBP≥110 mmHg,n=65）,采用24小时动态心电图记录的各组研究对象的HRV资料,分析和比较各组间HRV的5项时域指标SDNN、SDANN、HRV三角指数、RMSSD、PNN50之间的差异.结果 3组高血压组的5项HRV时域指标均低于健康对照组（P＜0.05）;高血压1级组、高血压2级组、高血压3级组三组之间的5项时域指标依次降低,其中SDNN、SDANN、HRV三角指数在对照组、高血压1级组、高血压2级组、高血压3级组任意两组之间比较,差异均具有统计学意义（P均＜0.05）.结论 高血压患者存在自主神经功能受损,并且随着血压分级水平的升高,自主神经受损逐渐加重.     

老年高血压患者心率变异性与血压晨峰现象

目的探讨老年高血压患者血压晨峰与心率变异性(HRV)的关系。方法老年高血压患者124例,按血压晨峰程度是否超过23.6 mmHg 分晨峰组与非晨峰组,所有病例进行动态心电图检查,分析 HRV 时域参数大小。结果 (1)与非晨峰组比较,晨峰组 HRV 时域指标(SDNN,SDANN,RMSSD,PNN50)显著降低(P<0.01);(2)按 HRV 时域参数 SDNN≤50 ms 程度统计,晨峰组发生率明显高于非晨峰组(P<0.05);(3)按 HRV时域参数100 ms>SDNN>50 ms 晨峰组发生率明显高于非晨峰组(P<0.01)。结论老年高血压患者晨峰程度越大,心率变异性时域指标降低越明显,提示自主神经损害严重。     

高血压患者心率减速力与室性心律失常

目的研究高血压患者的心率减速力,并分析其与室性心律失常的相关性。方法筛选无糖尿病和其他致自主神经功能损伤疾病的原发性高血压患者180例,以及同期健康体检者60例作为对照组,进行24h动态心电图检查,离线计算DC值、HRV时域指标,最后进行高血压与健康对照人群的对比分析,以及高血压患者的DC值和HRV时域指标与VA的相关性分析。结果高血压患者VA各组的DC值以及HRV时域指标的SDNN、SDANN、rMSSD、PNN50较对照组均显著降低（p〈0.05）,且高血压患者的DC、SDNN和SDANN与VA程度呈负相关（p〈0.05）。结论高血压患者的DC值及HRV明显降低,且DC、SDNN、SDANN和PNN50与高血压患者VA程度呈负相关。早期对自主神经功能紊乱进行干预治疗,可能有利于减少高血压患者VA的发生。     

降脂治疗对心率变异性影响的临床研究

目的 探讨血脂异常及降脂治疗对心率变异性(HRV)的影响.方法 选择成人血脂升高的80例患者分为辛伐他汀治疗组(A组)和高脂对照组(B组)各40例,以及血脂正常者(C组)60例,治疗前后行24 h动态心电图(DCG)检查测定其HRV时域指标.结果 ①与C组比较,B组HRV时域指标SDNN、SDANN、Rmssd及PNN50均显著降低(P＜0.01～0.05);②治疗前后HRV时域指标SDNN、SDANN、Rmssd及PNN50均明显改善(P＜0.01～0.05).结论 高脂血症者HRV各时域指标降低,同时降脂治疗能明显改善各项HRV指标.     

老年高血压患者心率变异性与血压晨峰现象

目的 探讨老年高血压患者血压晨峰与心率变异性(HRV)的关系.方法 老年高血压患者124例,按血压晨峰程度是否超过23.6 mmHg分晨峰组与非晨峰组,所有病例进行动态心电图检查,分析HRV时域参数大小.结果 (1)与非晨峰组比较,晨峰组HRV时域指标(SDNN,SDANN,RMSSD,PNN50)显著降低(P<0.01);(2)按HRV时域参数SDNN≤50 ms程度统计,晨峰组发生率明显高于非晨峰组(P<0.05);(3)按HRV时域参数100 ms>SDNN>50 ms晨峰组发生率明显高于非晨峰组(P<0.01).结论 老年高血压患者晨峰程度越大,心率变异性时域指标降低越明显,提示自主神经损害严重.     

老年高血压合并糖尿病患者心率变异性及其昼夜变化临床分析

目的研究老年高血压合并糖尿病患者的心率变异性(HRV)及其昼夜变化规律,探讨老年糖尿病患者心脏自主神经变化的临床意义。方法选择87例原发性高血压患者(EH组)及68例高血压合并糖尿病患者(EH+DM组),监测24 h动态心电图,进行HRV时域指标SDNN、SDANN、SDNN Index、RMSSD、PNN50的分析。比较2组间HRV指标的差异以及HRV昼夜指标差异。结果 EH+DM组较EH组24 h、日间、夜间HRV各项指标均明显降低,且有统计学差异;EH组SDNN以及RMSSD呈昼低夜高,但无明显统计学差异,SDNN Index和PNN50仍呈昼低夜高现象(P0.01);EH+DM组SDNN以及RMSSD呈昼高夜低现象(P0.05),SDNN Index和PNN50昼夜间无统计学差异。结论老年高血压合并糖尿病患者HRV显著降低,高血压患者昼夜节律已有明显受损,高血压合并糖尿病患者昼夜节律进一步受损,心脏自主神经功能失调。     

118例高血压患者不同时期自主神经功能评价

目的 探讨高血压病不同时期的自主神经功能损害程度。方法 原发性高血压（EH）患118例,按WHO高血压分期标准。对照组80例,均记录24h动态心电图（DCG）,进行心率变异（HRV）时域和频域分析。结果 ①EH组时域和频域指标均显低于对照组（P＜0．001）。②高血压Ⅲ期组SDNN、SDANN、HF明显低于Ⅰ、Ⅱ期高血压组（P＜0．05）,其它指标也有所下降。结论 EH HRV降低,心血管自主神经功能损害且与靶器官损害程度呈正相关。     

2型糖尿病治疗前后心率变异性分析

目的：观察2型糖尿病（type 2 diabetes mellitus,T2DM）患者治疗前后心率变异性（heart rate variability,HRV）的变化。方法选取48例T2DM患者作为糖尿病组,另选取50例健康志愿者作为对照组。观察 T2DM患者治疗前后 HRV 时域指标 SDNN、SDANN、rMSSD、PNN50和HRV频域指标LF、HF、LF／HF、VLF的变化,并与对照组比较。结果糖尿病组治疗前HRV时域和频域指标均低于对照组（P＜0．05）;与治疗前相比,糖尿病组治疗后HRV时域指标SDNN、SDANN、rMSSD、PNN50和 HRV 频域指标 LF、HF、VLF 均有不同程度的改善（P＜0．05）。结论 T2 DM患者存在心脏自主神经调节功能异常,以迷走神经受损为主,治疗后自主神经调节功能有不同程度的恢复。     

老年单纯收缩期高血压患者心率变异性分析

目的 探讨老年单纯收缩期高血压（EISH）患者心率变异性（HRV）时域指标变化，了解血压参数与HRV时域指标关系。方法 对32例老年单纯收缩期高血压患者，30例老年舒张期高血压患者，28例老年收缩、舒张双期高血压患者和30例健康老年人行24h动态心电图，检查、了解其24hHRV的时域指标。并对EISH患者的血压参数和HRV时域指标进行相关分析。结果 ①EISH患者与老年健康对照组比较SDNN、RMSSD、PNN50显著降低（P〈0．01，P〈0．01，P〈0．05）。②EISH患者与舒张期高血压组比较SDNN、RMSSD、PNN50显著降低（P〈0．01，P〈0．05，P〈0．01）。③EISH组患者收缩压与SDNN、PNN50、SDANN呈负相关（r=-0．865，P〈0．01；r=-0．923，P〈0．01；r=-0．878，P〈0．01）。平均动脉压（MAP-）与SDNN、PNN50、SDANN呈负相关（r=-0．461，P〈0．01；r=-0．481，P〈0．01；r=-0．458，P〈0．01）。结论 收缩期高血压患者较舒张期高血压患者自主神经功能损害更加明显。     

老年慢性阻塞性肺病患者窦性心率震荡及心率变异性的研究

目的 探讨慢性阻塞性肺病(COPD)患者窦性心率震荡(HRT)及心率变异性(HRV)变化及临床意义.方法 临床诊断为COPD老年患者59例,选择同期健康老年人30例为对照组.24 h动态心电图检测各组HRT参数:震荡初始(TO)和震荡斜率(TS)及HRV各项指标,肺功能检测,同时超声心动图测量左心室射血分数(LVEF)、右心房内径(RAD)、右心室内径(RVD)、右心室壁厚度(RVWT)等指标;组间比较且对HRT与HRV指标进行相关性分析.结果 与对照组比较,COPD患者TO值显著增高[(-0.2±1.1)%与(-3.8±2.8)%,t=6.830,P＜0.01],TS值显著下降[(7.0±3.6)与(11.7±6.1)ms/RR,t=3.866,P＜0.01];HRV指标正常R-R间期的标准差(SDNN)、正常R-R间期的标准差的平均值(SDNNI)、SDNNI的标准差(SDANN)、相邻R-R间期之差的均方根值(rMSSD)和正常R-R间期标准差≥50 ms的百分数(PNN50)增加,且随肺动脉压力的增高而恶化.TO与SDANN,rMSDD呈负相关(r=-0.369,P＜0.05;r=-0.472,P＜0.01),TS和SDNN,SDANN,PNN50呈正相关(P＜0.05),与rMSDD无相关性(P＞0.05).结论 COPD患者HRT现象减弱,HRT和HRV变化随患者肺动脉压力的增加而恶化,联合检测对评价COPD患者自主神经功能状态及预后有较高临床价值.

Abstract：

Objective To explore the clinical significance of sinus heart rate turbulence (HRT)and heart rate variability (HRV) in patients with chronic obstructive pulmonary disease(COPD).Methods The 59 moderate to severe COPD patients and 30 healthy subjects were enrolled in this study. The 24-hour holter monitor was used to screen the HRT onset (TO), turbulence slope (TS)and HRV. Pulmonary function tests and echocardiographic examination were performed for measuring left ventricular ejection fraction (LVEF), right atrial dimension (RAD), right ventricular dimension (RVD), right ventricular wall thickness (RVWT). Then all the parameters were compared between NC group and COPD group, and the relationship between HRT and HRV was investigated. Results Compared with control group, TO was significantly increased [(-0.2±1.1) % vs.(-3.8±2.8) %, t=6. 830,P＜0.01] and TS was decreased [(7.0±3.6) ms/RR vs. (11.7±6.1) ms/RR, t =3. 866, P＜0.01] in COPD group. In time domain HRV parameters, normal RR intervallerinin standart deviation(SDNN), standard deviation of normal-to-normal beats index (SDNNi), standard deviation of the averages of normal sinus to normal sinus (SDANN), mean squared differences of the successive RR intervals (rMSDD), fraction of consecutive normal sinus intervals that differ by more than 50 ms (PNN50) were significantly lower in COPD group than in control group(P＜0. 05). TO was negatively correlated with SDANN and rMSDD (r=-0. 369, P＜0. 05; r=-0.472, P＜0.01).TS was positively correlated with SDNN, SDANN and PNN50 (all P＜0.05), but had no correlation with rMSDD (P＞0. 05). Conclusions HRT and HRV are dramatically blunted in COPD patients.Combination of HRV and prognosis. and HRT may be simple and elegant ways for evaluating cardiac autonomic functions.     

心率变异时域分析对糖尿病患者自主神经功能的评价

采用２４小时动态心电图对８２例糖尿病患者进行心率变异（ＨＲＶ）和心率（ＨＲ）检测。８２例分为五组：Ａ组（无血管合并症）３０例、Ｂ组（合并大血管病变）１１例、Ｃ组（合并小血管病变）１２例、Ｄ组（同时合并大、小血管病变）１９例和Ｅ组（心肾功能不全）１０例，并设正常对照组。结果：糖尿病各组ＨＲＶ显著降低，Ａ组仅２４ｈ内全部正常ＲＲ间期标准差（ＳＤＮＮ，１０４．２０±２９．１９ｍｓ）和２４ｈ内５ｍｉｎ节段平均正常ＲＲ间期的标准差（ＳＤＡＮＮｉｎｄｅｘ，９３．７３±２７．５８ｍｓ）降低（对照组分别为１２７．５２±３８．５７ｍｓ和１１６．１９±３５．７０ｍｓ），Ｐ均＜０．０１；ＨＲ异常主要表现为夜间平均ＨＲ增快，白昼平均ＨＲ仅Ｅ组（８６．７６±１１．３６ｂｐｍ）高于对照组（７６．３８±９．４０ｂｐｍ），Ｐ＜０．０１。表明糖尿病患者存在自主神经受累，白昼心率增快可能是病情严重的征兆。     

750例健康儿童心率变异性分析

目的对750例健康儿童心率变异性（heart rate variability,HRV）进行分析,观察正常值范围及HRV与年龄的关系。方法对750例来我院体格检查的正常健康儿童分为以下6个年龄组：新生儿组（〈1个月）、婴儿组（1个月一1岁）、幼儿组（1～3岁）、学龄前组（3～6岁）、学龄组（6—11岁）和青春期组（11—16岁）,进行24h动态心电图检测,分析HRV时域（SDNN、SDANN、PNNSO、rMSSD）及频域（TF、VLF、LF、HF、LF／HF）结果。结果（1）各年龄组HRV时域分析SDNN、SDANN、rMSSD差异有统计学意义（P〈0．05或P〈0．01）,随年龄增长,HRV有增大趋势。（2）HRV频域分析TF、VLF、LF、HF差异有统计学意义（P〈0．01）,数值随年龄增大而增大。结论不同年龄段HRV时域及频域结果不同,HRV随年龄增加而增大,可对临床研究异常HRV提供参考依据。     

Heart rate variability in heart failure

BACKGROUND: Heart rate variability (HRV) depicts the functional status of the autonomic nervous system and its effects on sinus node. Recently, HRV analysis has been introduced in patients with heart failure (CHF) to identify those who are at risk of cardiac death. AIM: To analyse HRV in patients with CHF with depressed left ventricular ejection fraction (EF) and to relate HRV parameters to EF, NYHA functional class and other clinical parameters. METHODS: The study group consisted of 105 patients with CHF (88 males, 17 females, mean age 54+/-12 years); 77 patients had ischaemic cardiomyopathy, and 28 - dilated cardiomyopathy. All patients were in NYHA class II-IV and had EF <40%. The mean value of echocardiographically assessed EF was 26.9+/-8.3%. The control group consisted of 30 gender- and age-matched healthy subjects. HRV analysis was performed in the time-domain from 24-hour Holter ECG. RESULTS: All HRV variables were significantly lower in patients with CHF than in controls. Patients with NYHA class II had higher values of SDNN and SDANN than those in class III or IV. Patients with sustained or non-sustained ventricular tachycardia (VT) detected during Holter monitoring had lower SDNN and SDANN values than those without VT. Patients with diabetes had significantly lower SDNN and rMSSD values than the patients without diabetes. Similar results were found when patients with or without hypertension were compared. HRV parameters were similar in patients either with ischaemic or dilated cardiomyopathy. Also the values of EF were similar (27.4+/-8.4 vs 25.0+/-8.3%, respectively, NS). In the whole group of patients with CHF the values of SDNN and SDANN significantly correlated with EF (SDNN p<0.001, r=0.42; SDANN p<0.001, r=0.51). This correlation was stronger in the subset of patients with ischaemic cardiomyopathy (SDNN p=0.002. r=0.54; SDANN p=0.002; r=0.53) than in those with dilated cardiomyopathy (SDNN p=0.012, r=0.23; SDANN p=0.008, r=0.42). A significant negative correlation was found between all HRV parameters and NYHA class (SDNN p<0.001, r = -0.33; SDANN p<0.001, r = -0.38; rMSSD p<0.001, r = -0.13). CONCLUSIONS: HRV is depressed in patients with CHF compared with healthy subjects. Among patients with CHF, HRV is further decreased in patients with more advanced NYHA class, lower EF and in those with diabetes, hypertension or VT on Holter monitoring.     

Effects of cigarette smoking on the circadian rhythm of heart rate variability

BACKGROUND: The effects of cigarette smoking on the circadian rhythm of heart rate variability (HRV) are not known. METHODS: We studied the effects of cigarette smoking on the circadian rhythm of HRV in 24 smoking and 21 non-smoking healthy subjects. Twenty-four hour ambulatory electrocardiograms were recorded and time domain parameters of HRV (SDNN [standard deviation of all R-R intervals], SDANN [standard deviation of the averages of R-R intervals in all 5-minute segments of the entire recording], RMSSD [the square root of the mean of the sum of the squares of differences between adjacent R-R intervals]) were determined for the entire 24-hour period and for each 3-hour period. RESULTS: In total, SDNN and SDANN were significantly lower in smokers than non-smokers (116 +/- 26 vs 136 +/- 27, p < 0.05 for SDNN, 109 +/- 25 vs 121 +/- 24, p < 0.05 for SDANN). However, there were no statistical differences between smokers and non-smokers in heart rate (81 +/- 9 vs 76 +/- 10, p > 0.05) and RMSSD (32 +/- 12 vs 37 +/- 18, p > 0.05). These HRV parameters showed a circadian variation: they increased at night and decreased during the day in both groups. The parameters were lower in smokers than non-smokers during daytime (especially, between 8-14 hours). However, no differences were detected during night-time. CONCLUSIONS: Time domain parameters of HRV (SDNN, SDANN and RMSSD) in both smoking and non-smoking healthy subjects have a circadian rhythm. SDNN and SDANN were lower in smokers than non-smokers during daytime.     

Heart rate variability in healthy children and adolescents is partially related to age and gender.

We evaluated 24-h time-domain heart rate variability (HRV) in 103 (46 females) healthy children and adolescents. Subjects were divided into four male and four female groups (ages 1-5, 6-10, 11-15, 16-20 years) and 24-h ambulatory Holter monitoring was performed. HRV was assessed by SDNN, SDNN index (SDNN-i), SDANN, rMSSD, pNN50. Males showed SDNN and SDANN values significantly higher than females while for SDNN-i, rMSSD, pNN50 there were no significant differences between sexes. With increasing age, there is a progressive and significant decrease of HR and increase of SDANN. On the other hand, SDNN, SDNNi, pNN50 and rMSSD increased significantly only between the first two age-groups. rMSSD and pNN50 were significantly related to body mass index. Thus, SDNN and SDANN, overall HRV measures, increased with age and were gender-related. HRV indices of parasympathetic function (rMSSD, pNN50) and SDNN-i increased up to 10 years of age and were gender-unrelated. These data demonstrate that in healthy children and adolescents there is a progressive modification of HRV that may reflect a progressive evolution of the autonomic nervous system, with different pattern measure-dependent. This paper enables us to compare, in future works, HRV in pediatric subjects in different groups according to the different HRV measures under examination.     

2型糖尿病下肢神经病变心率变异性时域指标的昼夜节律

目的 了解糖尿病合并周围神经病变患者的自主神经功能.方法 2008年1月至2009年3月按随机数字表法抽取天津医科大学代谢病医院的117例2型糖尿病患者,分为2型糖尿病不伴下肢神经病变组(糖1组)59例和2型糖尿病伴下肢神经病变组(糖2组)58例.无糖尿病的对照组50例来源于我院健康体检者.受试对象均接受体重指数、收缩压、舒张压、甘油三酯、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、空腹血糖、餐后2 h血糖、糖化血红蛋白、空腹胰岛素、稳态模型胰岛素抵抗指数、24 h动态心电图心率变异性(HRV)、乏式动作反应指数、30/15比值、呼吸差的检测.统计学处理采用卡方检验、方差分析、配对秩和检验.结果 (1)糖1组、糖2组患者心动周期标准差(SDNN)、每5 min R-R均值的标准差(SDANN)、每5 min R-R均值的标准差指数(SDNNIDX)、相邻R-R差值的均方根(rMSSD)、24 h内相邻R-R间期相差＞50 ms的个数占总心跳次数的百分比(pNN50),与对照组比较差异有统计学意义(F值分别为94.702、77.786、55.422、56.175、49.110,均P＜0.01);(2)对照组SDNN、rMSSD、pNN50日间节律分别为(113±20)ms、(31±15)ms、4%(0～45%),夜间节律分别为(104±25)ms、(38±18)ms、11%(0～45%),日夜间比较差异有统计学意义(t=2.472、4.629、5.007,均P＜0.05);糖1组SDNN Et间节律为(81±16)ms,夜间节律为(77±19)ms,日夜间节律比较差异无统计学意义(t=1.952,P＞0.05),糖2组SDNN、rMSSD、pNN50日间节律分别为(64±15)ms、(21±19)ms、1%(0～30%),夜间节律分别为(64±20)ms、18(7～97)ms、1%(0～28%),日夜间节律比较差异无统计学意义(t值分别为0.155、1.103、1.328,均P＞0.05).结论 2型糖尿病不伴及伴下肢神经病变组均存在自主神经功能受损,但后者的自主神经功能更明显受损.心率变异性时域指标的昼夜节律可有效判断自主神经损害.     

持续性心房颤动患者高敏C-反应蛋白、心房结构重构和长时程心率变异性的临床分析

目的本文拟探讨持续性心房颤动(AF)患者高敏C-反应蛋白(Hs-CRP)、心房结构重构对长时程心率变异性(HRV)的影响。方法纳入35例持续性AF患者作为AF组,35例健康体检者作为对照组。行24h动态心电图检查,检测HRV时域指标,同时检测左心房直径(LAD)和Hs-CRP。结果 AF组HRV时域分析较对照组下降(P0.01);LAD较对照组增大(P0.05);Hs-CRP水平较对照组升高(P0.05)。LAD40 mm亚组SDNN、SDANN、RMSSD、PNN50值均低于LAD≤40 mm亚组,同时Hs-CRP水平高于LAD≤40 mm亚组,差异有统计学意义(P0.05)。结论 AF患者左心房组织结构发生改变,Hs-CRP水平升高,分布于心脏组织的自主神经紊乱,HRV降低。     

原发性高血压心率变异性测定的意义

目的：探讨原发性高血压患不同时期心率变异性的改变。方法：记录原发性高血压病人46例,对照组23例的24小时动态心电图,进行心率变异性的时域分析。结果：（1）原发性高血压组时域分析的各项参数指标除PNN50外,SDNN、SDANN、SDANNindex,rMSSD显减低（P＜0．01）;（2）随高血压病程进展（1、2、3级）SDNN、SDANN、SDANNindex逐渐降低,各项之间均存在极显的差异。结论：原发性高血压患的HRV显减低,且随病程进展,变化愈显,提示HRV分析对高血压患有分层及预后的价值。