扩张型心肌病患者的心率变异性分析(附26例报告)

对２６例扩张型心肌病患者进行心率变异性（ＨＲＶ）时域和频域指标分析，并与正常人对照；根据射血分数降低程度，将２６例患者分成两个亚组，进行心率变异性（ＨＲＶ）分析对照。结果发现：扩张型心肌病组ＨＲＶ时域指标平均Ｒ－Ｒ间期标准差（ＳＤＮＮ）、连续正常Ｒ－Ｒ间期差值的均方根（ｒＭＳＳＤ）和相邻的正常Ｒ－Ｒ间期差值＞５０ｍｓ的百分比（ｐＮＮ５０）均显著低于正常对照组（Ｐ＜０．００１），频域指标低频（ＬＦ）和高频（ＨＦ）值均明显降低（Ｐ＜０．０１），低频／高频（ＬＦ／ＨＦ）明显升高（Ｐ＜０．０１）。两个亚组比较，射血分数（ＥＦ）显著减低组ＨＲＶ时域指标ＳＤＮＮ、ｒＭＳＳＤ和ｐＮＮ５０均显著低于ＥＦ轻度减低组（Ｐ＜０．００１、Ｐ＜０．０１、Ｐ＜０．０５）。频域指标ＨＦ成份明显减低（Ｐ＜０．０１）；ＨＦ减低无显著性差异（Ｐ＞０．０５）；ＬＦ／ＨＦ无显著性差异（Ｐ＞０．０５）。说明扩张型心肌病患者的心脏迷走神经活性显著降低，同时伴交感神经活性降低，但迷走神经活性降低更为明显。提示植物神经系统在扩张型心肌病的发病机制中可能起有一定作用；扩张型心肌病随心衰的加重，ＨＲＶ指标进一步减低。

The Analysis of Heart Rate Variability of 26 Patients with Dilated Cardiomyopathy

Theauthorsanalyzethedataonthetimeandfrenquencyrangesoftheheartratevariability(HRV)ofthe26patientswithdilatedcardiomyopathyTheyalsocomparethedatawiththoseofnormalpeopleandaccordingtothereductionofEF,theydividethe26casesintotwosubqroups,thenanalyzeandcomparetheirHRVdatatheyfindthedilatedcardiomyopathypatientshavefarlowerSDNNrMSSDandpNN50intheHRVtimerange(P<001)ThereisadistinctdropofLFandHFintheHRVfrequencyrangeofthepatients(P<001),andthepatients'ratioofLF/HFisobviouslygettinghigher(P<001)Thentheycomparethetwosubgroupsofdilatedcardiomyopathypatients,andfindthegroupwithadistinctreduction ofEFhasfarlowerSDNNrMSSDandpNN50intheHRVtimerangethanthegroupwitha slightreduction ofEF(P<0001P<001P<005)TheformergroupshowsadistinctdropofHFintheHRVfrequencyrange(P<001),anotsoobviousdropofLF(P>005)andanalmostthesameratioofLF/HF(P>005)Theauthorsconsider:Theactivityofthevagusnervesintheheartsofthepatientswithdilatedcardiomyopathyisweakenedmuchmorethanthatoftheactivityofthesympatheticnerve,ItindicatesthePotentialrolethat