窦性心率震荡检测方法及影响因素的研究

目的 探讨窦性心率震荡（HRT）的测量方法及影响该指标测量的临床因素。方法 随机选择我院门诊接受24h动态心电图（Holter）检查并记录有室性早搏（VPC）的健康体检者50例，分别计算窦性心率震荡的震荡初始（TO）、震荡斜率（偈）及震荡斜率起始时间（TT），分析各参数与年龄、室早前基础心率等因素之间的相关关系．并比较不同基础心率段各参数之间的差别。结果 先计算每个室早的窦性心率震荡参数，然后求平均值所得的偈、TT值较先平均RR值再计算窦性心率震荡所得的偈、TT值高；窦性心率震荡与年龄、室早前基础心率、代偿间期以及室早数目相关，与联律间期不相关；且不同基础心率段TO、TS指标差异具有显著性（p〈0．05）。结论 计算窦性心率震荡之前就取RR间期平均值然后测量可能提供更好的死亡预测率：应用窦性心率震荡时应同时考虑到年龄、室早前基础心率、代偿间期及室早数目对其的影响.

Study of measurements and influential factors of heart rate turbulence

Objective To investigate the measurements and clinical influential factors of heart rate turbulence(HRT).Methods 50 healthy persons who accepted examination of 24 hours ambulatory electrocardiograph(Holter) and showed ventricular premature complexes(VPC) in records were enrolled randomly.24h Holter data of subjects were collected and processed to obtain the values of turbulence onset(TO),turbulence slope(TS) and turbulence timing(TT).The correlation of TO,TS,TT and age,basic heart rate before VPC(HRVPC),et al was analyzed and each parameter of HRT in different segments of HR was compared.Results The values of TS and TT computed by calculating HRT of every VPC first were significantly higher than by averaging RR intervals first(p<0.05).HRT was influenced by age,HR before VPC,compensatory interval and the number of VPC and didn't correlate with coupling interval,and TO and TS were significantly different in each segment of HR before VPC(p<0.05).Conclusion Taking averages of RR intervals before computing HRT may be provide better prediction rate of death,and age,HR before VPC,compensatory interval and the number of VPC should be allowed when using HRT.