充血性心力衰竭患者的心率变异性及其意义

Heart rate variability and its clinical significance in patients with congestive heart failure

对２８例充血性心力衰竭（ＣＨＦ）患者及１０例健康正常人的２４ｈ动态心电图资料进行分析。每４ｍｉｎ计算１次Ｒ－Ｒ间期标准差（ｓ），以ｓ＜５０ｍｓ、５０～１００ｍｓ、＞１００ｍｓ的心跳所占的时间百分比（Ｐｓ＜５０、Ｐｓ５０～１００、Ｐｓ＞１００）作为评价心率变异性（ＨＲＶ）的指标，发现ＣＨＦ患者较正常人Ｐｓ＜５０、Ｐｓ５０～１００增加，而Ｐｓ＞１００降低（均Ｐ＜０．０５），证明了ＣＨＦ患者存在ＨＲＶ降低的现象。并认为其降低可能与心衰时交感神经系统反射调节异常有关；ＨＲＶ可作为ＣＨＦ预后的预测指标之一。

Abstract In the present study,twenty-four-hour ambulatory electrocardiography tapes in 28 patients with congestive heart failuce(CHF) and 10 healthy normal persons were analysed.HRV was evaluated by calculating the standard deviation(SD) of every four-minute R-R intervals and the percentage of the heart beats which R-R interval SD was smaller than 50ms,50～100ms and greater than 100ms respectively(PSD<50,PSD 50～100,PSD>100).The results show thatPSD<50,PSD50～100 was significantly increased and PSD>100 reduced in CHF patients than normal individuals(P<0.05).This study indicates that CHF patients have lower HRV.The author consider that the decreased HRV in CHF patients may be related to the abnormal sympathetic reflex regulation,and HRV may be one of the prognostic predictors in CHF patients.