冠心病患者冠脉动脉病变严重程度与心率震荡斜率相关

目的评价冠心病与心率震荡、心率变异的关系。方法对20例经冠脉造影术确诊的冠心病患者,20例高血压患者（经冠脉造影术排除冠心病）与20例正常体检者进行心率变异指标和心率震荡参数比较。并对冠脉病变与各项指标进行线性回归分析,进一步评价心率变异、心率震荡指标与冠脉病变程度的相关性。结果冠心病患者组心率变异指标SDNN（100±7）ms、SDNNI（39±3）ms和心率震荡参数TS（3.0±2.3）均低于正常体检组的SDNN（131±6）ms、SDNNI（53±3）ms、TS（6.7±1.3）（P<0.01）,而高血压患者组仅SDNN（109±6）ms、SDNNI（44±3）ms低于正常体检组（P<0.05）;研究还发现冠心病组TS（3.0±2.3）低于高血压组TS（6.0±1.6）（P<0.01）。对冠脉病变与各项检测指标进行线性回归分析后发现,TS与冠脉的狭窄程度呈负相关（r=-0.61,P<0.01）,与冠脉病变评分呈负相关（r=-0.462,P<0.05）。将冠脉按照病变程度进行分组发现,冠状动脉病变狭窄程度≥50%的TS值显著变小（P<0.01）,多支病变的TS明显变小（P<0.05）,冠脉病变评分高于10分组TS值显著变小（P<0.05）。结论冠心病患者的心率震荡参数TS显著减小,并且TS与冠状动脉粥样硬化严重程度有一定相关性。

Changes of heart rate turbulence in coronary heart disease

AIM To evaluate the relationship between coronary heart disease(CHD) and parameters of heart rate turbulence(HRT) by angiographic examination,and HRT and heart rate variability(HRV) analysis.METHODS Twenty patients with CHD,20 patients with hypertension and 20 healthy controls were involved in the study.24-hour ambulatory electrocardiogram was performed in all the patients and the parameters of HRT and HRV were obtained,including the parameters of HRT(TO,TS) and HRV(SDNN,SDANN,rMSSD,SDNN Index,PNN50).All the patients underwent angiographic examination by the Jukdins technique. RESULTS Compared with those in the control group,SDNN,SDNNI and TS were markedly and significantly reduced in CHD patients(P<0.01),but only SDNN and SDNNI in hypertension patients were markedly lower than those in control group.(P<0.05).TS in CHD group was lower than that in hypertension group(P<0.01) and TS was markedly lower in more severely narrow coronary arteries.CONCLUSION The TS of HRT significantly reflects the severity of the CHD and significantly reduces in CHD patients(P<0.01).Compared with that in hypertension patients,TS reduces in CHD patients(P<0.01).TS is,to some degree,correlated with the severity of coronary vessel diseases.