冠状动脉病变对心率变异性的影响

目的探讨冠心病患者冠状动脉病变对心率变异性（HRV）的影响。方法 158例患者经冠状动脉造影按病变程度分为非阻塞组（Cn,62例）,部分阻塞组（Cp,56例）,完全阻塞组（Cc,40例）。96例阻塞患者再按病变部位、支数分亚组。术前行24h动态心电图检查,计算HRV的时域指标：SDNN、SDANNind、SDNNind、RMSSD、PNN50。分析不同冠脉病变间HRV的差异。结果 Cc与Cn、Cp比较,SDNN、SDANNind、SDNNind下降明显,差异有统计学意义（P〈0.05）;Cp与Cn比较,SDNN、SDANNind下降明显,差异有统计学意义（P〈0.05）;3支病变组与1支、0支病变组比较,HRV各指标下降显著,差异有统计学意义（P〈0.05）;左支病变组与Cn比较SDNN、SDANNind下降明显,差异有统计学意义（P〈0.05）。结论 HRV对冠状动脉病变评估有一定意义。

Effects of coronary artery lesion on heart rate variability

Objective To investigate the effects of coronary artery lesion on heart rate variability（HRV） in patients with coronary artery disease（CAD）.Methods By coronary angiography（CAG）,158 patients were divided into non occlusion group（Cn,n=62）,partly occlusion group（Cp,n=56） and completely occlusion group（Cc,n=40）.Ninety-six cases with coronary artery occlusion were divided into one branch lesion group（C1,n=38）,two branches leision group（C2,n=25）,three branches leision group（C3,n=33）;left coronary artery abnormality group（CL,n=72）and right coronary artery abnormality group（CR,n=24）;before CAG,all cases were performed 24 hour ambulatory electrocardiogram and analysed result of time-domain HRV（SDNN,SDANNind,SDNNind,RMSSD,PNN50）.Results In Cc,SDNN,SDANNind and SDNNind were significantly lower than Cn and Cp（P0.05）;in Cp,SDNN and SDANNind were significantly lower than Cn（P0.05）;in C3,HRV were significantly lower than C1 and Cn（P0.05）;in CL,SDNN and SDANNind were significantly lower than Cn（P0.05）.Conclusion HRV had very good clinical practical value for predict the diagnosis and monitor change of CAD.