冠状动脉病变患者的心率变异分析

Analysis of heart rate variability of patients with coroonary heart disease

目的:通过分析冠状动脉(coronaryartery,CA)病变患者的心率变异(heartratevariability,HRV)和有否侧支循环对HRV的影响,了解冠状动脉病变和侧支循环与自主神经功能紊乱之间的关系。方法:对93例CA病变患者用时域分析法对心率变异性各项指标进行了检测,并与100例CA各支直径减少<50%的对照组比较。结果:CA病变组与对照组相比,心率变异的各项指标全部正常R鄄R间期的标准差(SDNN)和其均值(SDNNI)、正常相邻R-R间期差值的均方根(rMSSD)和其值>50ms(PNN50)的百分比无差别(P>0.05)。根据有否侧支循环把CA病变组分为A(无侧支循环)组和B(有侧支循环)组。两组相比,代表心率总变异程度的SDNN和SDNNI明显降低(P<0.01),代表迷走神经功能的rMSSD和PNN50也有下降(P<0.05)。结论:无侧支循环的CA病变患者的HRV比有侧支循环的CA病变患者低,侧支循环对CA病变患者的心脏自主神经功能可能有保护作用。

Objective: To investigate correlation between coronary artery lesions(CA), collateral circulation and autonomic nerve's functional disturbance through analysis of heart rate variability(HRV) of patients with CA, as well as collateral circulation's influence on HRV. Method: Various HRV indices of 93 patients with CA had been tested by time domain analysis and compared with 100 cases from comparison group with decreased diameter no more than 50 percent. Result: Indices such as SDNN, SDNNI, rMSSD had no significant difference with PNN50(P < 0.05). Patients were divided into two groups: Group A(no collateral circulation) and Group B(with collateral circulation). The result showed that group A's SDNN and SDNNI, reflecting the general HRV degree, were obviously lower than group B's(P < 0.01). The same case could also be found in rMSSD and PNN50(P < 0.05), which represented vagus nerve. Conclusion: HRV degrees of CA patients without collateral circulation are lower than those with collateral circulation, which may indicated that collateral circulation is protective to coronary autonomic nerve function.