绝经后妇女冠心病患者性激素水平与心率变异性及QT离散度相关性研究

目的 :探讨绝经后妇女冠心病患者性激素水平变化与心率变异性 (HRV)及QT离散度 (QTd)的关系。方法 :分别检测 60例不同年龄段健康妇女及 2 0例绝经 1年以上的冠心病妇女的血清E2 、P、T水平 ,分析HRV ,计算QTd ,并在低雌激素水平将健康妇女与冠心病妇女的E2 、HRV及QTd进行比较。结果 :与健康妇女相比 ,冠心病妇女在E2 水平、SDNN、SDANN、SDNNI、TP、LF、HF及LF/HF(P <0 .0 5 )明显降低 ,QTd延长 (P <0 .0 5 )差异均有显著性。低雌激素健康妇女E2 与HRV、QTd无相关性 ,而低雌激素冠心病妇女E2 与SDNN、SDNNI、TP、LF、LF/HF(P <0 .0 1)、SDANN(P <0 .0 5 )及QTd与SDNN、SDANN(P <0 .0 5 )呈显著相关性 ,E2 与QTd无明显相关。结论 :绝经后的冠心病妇女雌激素水平的降低导致自主神功能经失衡 ,而自主神经功能失衡可以改变心肌的电稳定性。

The correlation of sex hormones, heart rate variability and QT dispersion in postmenopausal women with coronary heart disease

Objective:To investigate the relationship among sex hormones,heart rate variability (HRV) and QT dispersion (QTd) in postmenopausal women with coronary heart disease (CHD).Methods:60 cases of healthy women and 20 cases of in postmenopausal women with CHD were included in this study.Serum estogen (E 2),progesterone (P) and testosterone (T) of all subjects were detected by radio immunoassay, HRV (include 24-hour time domain,5-minute frequence domain) were analyzed from 24-hour ambulatory ECG and QT dispersion were measured by 12-lead ECG.E 2,HRV and QTd were compared with depending on subjects lower levels of E 2.Results: E 2,SDNN,SDANN,SDNNI,TP,LF,HF and LF/HF were significantly lower,while QTd were significantly highter in women with CHD compared with healthy women.SDNN,SDNNI,TP,LF and LF/HF were signicantly positive correlated with serum E 2,while QTd was negative corredlation with SDNN and SDANN in CHD of low E 2.But E 2 was not correlation with QTd.Conclusion:The decreased estopgen cause the imbalance of autonomic nervous function in the elderly women with CHD,further alter the characteristic of myocardial electric stability.