慢性心力衰竭患者窦性心率震荡的临床意义

目的探讨慢性充血性心力衰竭(CHF)患者窦性心率震荡(HRT)与心功能程度的关系。方法慢性心衰患者(CHF组)85例,全部病例按纽约心脏病协会(NYHA)心功能分级,分为轻度CHF组(心功能Ⅱ级)45例和重度CHF组(心功能Ⅲ～Ⅳ级)40例。另选同期心功能正常的42例作为对照组。所有入选者均接受24h动态心电图检查,分别计算窦性心率震荡的初始值(TO)、震荡斜率(TS),并进行统计学分析。结果3组的TO均值比较,重度CHF组与对照组比较差异有统计学意义(P<0.01);轻度CHF组与对照组比较差异有统计学意义(P<0.05);3组间的TS均值组间两两比较差异均有统计学意义(P<0.01)。结论伴随CHF患者程度加重,HRT现象明显变钝减弱,其变化可能与自主神经的变化有关。

Detection and Clinical Significance of Heart Rate Turbulence in Patients with Chronic Heart Failure

Objective To explore the relationship between heart rate turbulence (HRT) and the degree of heart function in patients with chronic heart failure (CHF). Methods 85 patients with CHF were divided into two groups according to New York Heart Association (NYHA) functional classification. Group A included 45 patients with Ⅱ degree and group B include 40 patients with Ⅲ-Ⅳ degree. The control group includes 42 patients with normal cardiac function. All patients received Holter EKG examination. The turbulence onset (T0) and turbulence slope (TS) of HRT were calculated individually and statistic analysis were done. Results There were extremely significant difference between group B and control group (P<0.01), significant difference between group A and control group (P <0.05) in TO. There were extremely significant difference between every two among three groups (P<0.01) in TS. Conclusion The phenomenon of HRT decline with the Decreasing of heart failure, which was suspected to be related with change of autonomic nerve.