特发性肺间质纤维化患者心率变异性时域分析

目的　通过心率变异性 (heart rate variability,HRV)时域分析评价特发性肺间质纤维化 (idiopathicpulmonary fibrosis,IPF)患者心脏自主神经功能损害。方法　分别对 1 6例有 型呼吸衰竭、1 3例无呼吸衰竭的IPF患者和 2 4例正常人进行 2 4小时动态心电图监测及 HRV时域分析。结果　 IPF患者 HRV各项指标 SDNN、SDANNI、SDNNI、r MSSD及 PNN5 0均明显低于正常对照组 (P<0 .0 5或 0 .0 1 ) ,尤其以存在 型呼吸衰竭的患者更明显。上述时域指标与 DLCO、Pa O2 呈正相关 (r值 0 .73～ 0 .89,P<0 .0 5 )。结论　 IPF患者心脏自主神经功能受损 ,HRV时域分析可作为一种无创性评价 IPF患者心脏自主神经功能的方法

The time domain analysis of heart rate variability in idiopathic pulmonary fibrosis patients

Objective To evaluate cardiovascular autonomic nervous function in patients with idiopathic pulmonary fibrosis (IPF) by 24-hour rate variability (HRV) monitoring with time domain analysis.Methods 24-hour electrocardiogram recording and HRV time domain analysis were performed in 16 IPF patients with type I respiratory failure, 13 IPF patients without respiratory failure and 24 healthy controls. Results When compared with the controls, SDNN, SDANNI, SDNNI, rMSSD and PNN50 were markedly reduced in IPF patients (p<0.05 or 0.01). Furthermore, the differences were much more pronounced in IPF patients with type I respiratory failure. Correlation analysis indicated that SDNN, SDANNI, SDNNI, rMSSD and PNN50 were positively related to DLCO and PaO2 (r=0.73~0.89, p<0.05).Conclusion on Patients with IPF experience cardiovascular autonomic nervous dysfunctions. The time domain analysis of HRV is a non-invasive method for evaluating cardiovascular autonomic nervors function in IPF patients.