病毒性心肌炎儿童窦性心率震荡及与其他指标的相关性研究

目的研究窦性心率震荡（HRT）对儿童急性病毒性心肌炎（VMC）的诊断价值及其HRT与其他指标的相关性。方法随机抽取急性VMC患儿75例及77例健康儿童，均接受24h动态心电图检查，分别计算出HRT的震荡初始值（To）及震荡斜率（Ts），比较它们之间的差异。同时，记录VMC患儿的室性期前收缩（VPC）数目，是否伴有室性心动过速（VT）以及心率变异性（HRV）中的SDNN指标。分析它们与To、Ts的相关性。结果VMC患儿的To、Ts与对照组相比，差异有统计学意义分别为（1．47±2．03）％，（-0．78±2．55）％，P〈0．01及（3．05±2．12）ms／RR，（8．82±3．42）ms／RR，P〈0．01]。VMC患儿的To与VPC数目无相关性。Ts与VPC数目呈负相关，To、Ts与是否伴有VT及HRV均元相关性。结论急性VMC患儿的HRT明显减弱。Ts可能是急性VMC患儿较有力的危险预测指标；另外，研究还发现，HRT是一个独立于传统使用HRV来评价心脏自主神经功能的新指标。因此，通过分析VMC患儿的HRT来评价其心脏自主神经功能状态，有助于早期发现心脏自主神经病变。

The correlation between heart rate turbulence of pediatric viral myocarditis and other indexes

Objective To study the value of heart rate turbulence(HRT) of acute pediatric viral myocarditis (VMC) ,and the relationship between HRT and other indexes. Methods We randomly assigned 75 acute pediatric VMC and 77 health enfant those all received holter. We calculated the heart rate turbulence(To) and turbulence slope (Ts) respectively,and compared the difference between them. Simultaneously, record the number of ventricular pre-mature complex(VPC) ,whether with ventricular tachycardia(VT) and the SDNN index of HRV. Then we analyzed the association between them and To,Ts. Results The difference of To between pediatric VMC and control group is significant in statistics, as follows (1.47±2.03 ) %, (-0.78±2.55) %, P<0.01; (3.05±2.12) ms/RR, (8.82±3.42) ms/RR,P<0.01]. There are no correlation between To and the number of VPC. And the number of VPC is interrelated to Ts. To and Ts are not correlative with whether with VT and heart rate variability(HRV). Conclusions The HRT of pediatric VMC is significanty reduced,so HRT can be a new index that to evaluate the heart parasym-pathetic function state in pediatric VMC and it is independent from traditional HRV. Therefore we can evaluate the heart parasympathetic function state of the sufferers after analyzed their HRT. This technique can help to discover pathological changes of heart parasympathetic system in forepart and guide clinical therapy in time,and avoid heart ill event.