慢性肺心病患者的心率变异性

目的：观察慢性肺心病患者心率变异性，了解其自主神经功能的变化。方法：对25例慢性肺心病，25例健康对照者（对照组）作前瞻性对照研究，记录24h动态心电图，作时域和频域分析，结果：与对照组比较，肺心病组相邻心搏的R－R间期之差＞50ms的心搏数占R－R间期数的百分(pNN50)，每5min正常R－R间期标准差的平均值（SDANN），频域指标的高频（HF）明显降低，低频与高频的比值（LF／HF），明显升高，差异均有非常显著意义（P均＜0．01），而频域指标的低频（LF）无明显变化（P＞0．05），经过治疗后，肺心病组处于缓解期，与治疗前比较，HF，PNN50，SDANN等指标明显增加，而LF／HF明显降低，差异均有非常显著意义（P均＜0．01），肺心病组病人治疗后HF，pNN50,SDANN等指标均低于对照组，而LF／HF明显高于对照组，差异均有非常显著意义（P均＜0．01），肺心病组治疗后LF与治疗前及对照组比较，差异不具显著意义（P＞0．05）。结论：肺心中层得不仅交感神经活动占优势，同时并存迷走神经功能受损，自主神经功能可能存在连续性障碍。

Heart Rate Variability in Patients with Chronic Cor Pulmonale

Obsjective:To observe the changes of autonomic nervous system in patients with chronic cor pulmonale.Methods:Heart rate variability(HRV)was analyzed by short HRV time methods in 25 patients with chronic cor pulmonale in acute attack and in 25 matched healthy adults.Results:The HF?pNN50?SDANN decreased and LF/HF increased in patients with chronic cor pulmonale in acute attack as compared with the controls(P<0.01),while LF decreased(P>0.05).After treatment,the HF?pNN50?SDANN markedly increased and LF/HF decreased in patients with chronic cor pulmonale as compared before treating(P<0.01).The HF?pNN50?SDANN in patients with chronic pulmonary heart disease after treating were lower than those of the controls,LF/HF was higher than that of the normal group(P<0.01).while LF was not markedly changed as compared with the normal group(P>0.05).Conculsion:It was suggested that the patients with chronic cor pulmonale usually with low HRV,marked sympathetic activation and the autonomic dysfuction due to vagal neuropathy.Autonomic nervous dysfuction may existed persisterly.