冠心病患者冠状动脉病变与心率变异性的关系

目的了解冠心病患者冠状动脉病变与心率变异性的关系，探讨心率变异性在评估冠心病病情方面的作用及意义。方法所有111例病人均行冠状动脉造影及24h动态心电图检查，按冠状动脉造影结果分为至少有一支冠状动脉完全阻塞、至少有一支冠状动脉有不同程度狭窄病变、冠状动脉造影完全正常3组；通过动态心电图检查计算心率变异性的时域指标：SDNN、SDANNind、SDNNind、rMSSD、PNN50，用SPSS12．0统计软件包对比不同冠状动脉病变之间心率变异性的差异。结果①随冠状动脉狭窄程度加重，心率变异性指标：SDNN、SDANNind、SDNNind渐下降，完全阻塞组这些指标下降最显著；②随冠状动脉病变支数增加，心率变异性指标：SDNN、SDANNind、SDNNind、rMSSD、PNN50有进一步下降趋势，但只有三支病变心率变异性下降才有统计学意义；③左冠状动脉病变心率变异性指标：SDNN、SDANNind明显下降，而右冠状动脉病变下降不明显。结论冠心病患者心率变异性明显下降提示冠状动脉狭窄程度重、病变范围广、病变在左冠状动脉，这对冠心病患者病情评估有一定意义。

The correlation between heart rate variability and coronary artery pathology in patients with coronary artery disease

Objective To investigate the correlation between heart rate variability (HRV) and coronary artery pathology and the significances of HRV in assessment the severeness of patients with coronary artery disease (CAD). Methods We performed coronary angiography in all 68 patients with CAD and 43 patients control subjects. We also analyzed time-domain HRV(SDNN,SDANNind,SDNNind,rMSSD,PNN50 ) in all 111 patients before angiography. All patients were classified to three groups according to coronary artery pathology,that is: those patients who have total occlusion at least in one of coronary artery,those patients who have narrowing at least in one of coronary artery,and those patients who have no disease in all coronary artery. We compare HRV between the three groups with SSPS12.0 statistics software. Results (1) Time-domain HRV (SDNN,SDANNind,SDNNind) were gradually lower with the degree of coronary narrowing in patients with CAD and HRV are lowest in patients with total occlusion at least in one of the three main coronary artery. (2) All time-domain HRV(SDNN,SDANNind,SDNNind,rMSSD,PNN50) tend to lower with the number of coronary artery. But HRV were significantly lower only in patients who have narrowed in all threee coronary arteries. (3) HRV(SDNN,SDANNind) were significantly lower in patients with left coronary artery disease.But there are no significantly tower in patients with right coronary artery disease. Conclusions HRV were significantly lower in patients with coronary artery disease indicate the patients have sever narrowing in his coronary artery and he may have sever narrowing in all three of his coronary artery or total occlusion in one of coronary artery or sever narrowing in his left coronary artery. [