老年心力衰竭患者心率震荡变化的临床观察

目的：研究窦性心率震荡（HRT）现象在老年慢性心力衰竭（CHF）患者中的变化，并探讨其临床意义。方法：在2007年1月～2009年3月期间在我院进行健康体检的患者和门诊患者，55例慢性心力衰竭的老年患者（心力衰竭组）和38例非器质性心脏病的老年健康体检者（对照组）均接受24小时动态心电图检查，分别计算窦性心率震荡的初始值（T0）、震荡斜率（TS）。并进行T0、TS与左室舒张末期内径（LVED）、左室射血分数（LVEF）、室早数目、室早前的心率、联律间期、代偿间期的相关性分析及不同起源室早T0、TS的组间比较。结果：老年慢性心力衰竭患者与老年健康者窦性心率震荡间存在明显差别，即，老年慢性心力衰竭患者T0明显高于对照者老年健康者，老年慢性心力衰竭患者TS明显低予对照者，T0、TS与左室射血分数、左室舒张末期内径、室早数目相关，与室早前的心率、联律间期、代偿间期、室早起源不相关。结论：老年慢性心力衰竭患者中窦性心率震荡现象明显减弱，由于T0、TS与左室射血分数、左室舒张末期内径等相关，可凭借T0、TS对老年慢性心力衰竭患者进行危险分层，但它对预后的预测价值等方面的研究，限于样本数量，有待大样本长期随访来实现。

Senile changes in heart rate turbulence in patients with heart failure clinical observation

Objective： To study the sinus heart rate turbulence （HRT） in elderly patients with chronic heart failure phenomena （ CHF ） patients with the changes and to explore its clinical significance. Methods： In January 2007 - 2009 3 - month period in our hospital for physical examination of patients and outpatients, 55 cases of elderly patients with chronic heart failure（ heart failure） and 38 cases of non - organic heart disease in elderly healthy persons（ control group ） were to receive 24 - hour ambulatory ECG, respectively, sinus calculation of the initial value of heart rate turbulence （T0）, turbulence slope （ TS ）. And TO, TS and left ventricular end - diastolic diameter （LVED） , left ventricular ejection fraction （ LVEF）, as early as the number of rooms, room earlier heart rate, interval bigeminy, compensatory relationship between the period of analysis and different origins room as early as T0, TS comparison group. Results： elderly patients with chronic heart failure in elderly patients and the healthy heart rate turbulence sinus significant differences exist between, that is, elderly patients with chronic heart failure patients was significantly higher than T0 healthy elderly controls, patients with chronic heart failure in elderly TS was significantly lower than controls, T0 , TS and left ventricular ejection fraction, left ventricular end diastolic diameter, number of rooms as early as related to heart rate and the room earlier, the law of inter - period interval compensatory, not related to the origin of room early. Conclusion： in elderly patients with chronic heart failure in sinus heart rate turbulence is much reduced, due to T0, TS and left ventrieular ejection fraction, left ventrieular end diastolic diameter, etc. , by virtue of T0, TS of elderly patients with chronic heart failure risk stratification , but its predictive value of prognosis studies, limited sample size, yet large sample to achieve long - term follow - up.