冠心病患者心率震荡与心率变异性的相关性研究

目的探讨心率震荡(HRT)和心率变异性时阈指标(SDNN)在冠心病(CHD)中的变化,以及它们之间的关系。方法选择有室性早搏的冠心病患者53例,根据24H动态心电图(HOLTER)记录资料分组,A组(良性室性心律失常组:偶发室早)32例,B组(不良室性心律失常组:伴有阵发性室性心动过速或多源性室早或频发室早)21例,动态心电图记录SDNN,计算心率震荡的两个参数:震荡初始(TO)和震荡斜率(TS),分析TO、TS与SDNN之间的相关性。结果B组TO值高于A组(0.80%±3.94%VS-1.45%±4.37%,P<0.05),而TS值低于A组(11.03±11.01ms/RR间期VS19.77±19.00ms/RR间期,P<0.05),B组TO与SDNN呈负相关,TS与SDNN无明显相关。结论冠心病患者伴有不良室性心律失常时,心率震荡现象减弱,提示心脏自主神经平衡的破坏,且与心脏内在的调节机制有关。

Correlation between turbulence and variability of heart rate in the patients with coronary heart disease

Objective To study the change of the heart rate turbulence （HRT） and standard deviation of normal-to-normal RR intervals （SDNN） in the coronary heart disease （CHD） ,and research the relationship between them. Methods Fifty-three patients with CHD were investigated, and they were divided into two groups according to the HOLTER record. Thirty-two patients in Group A who had benign ventricular arrhythmias and occasional premature ventricular contraction） , and twenty-one subjects in Group B who had non-benign ventricular arrhythmias and paroxys- mal ventricular tachycardia or multi-source or frequent ventricular premature beats）, Hoter records the SDNN, HRT onset and slope were measured by the original definitions using Holter records. Results The value of the HRT onset of Group B was significantly higher than that of Group A （ 0.80% ± 3.94% vs 1.45 ± 4.37 % , P 〈 0.05 ） , the val- ue of TS was lower than that of Group A （11.03 ± 11.01 ms/RR interval vs 19.77 ± 19.00 ms/RR interval ,P 〈 O. 05 ）, there was significant negative correlation between TO and SDNN in Group B, and no correlation between TS with SDNN. Conclusion Our study indicated that the damaged autonomic nerve function of heart may correlate with non- benign ventricular arrhythmias, and correlate with the inset regulation Of heat itself.