长航对人24h动态心电图ST段及室性早搏者心率变异性变化的影响

Influence of long voyage on the change of ST segment and the correlation between ventricular premature beat and heart rate variability

目的 :观察长航对人ST段及室性早搏者心率变异性变化的影响。方法 :对 81名长航人员分别于航前 15～ 5d和航行中第 6 5～ 75d、 115～ 12 5d行 2 4h动态心电图检查 ,对其中的 32名于航后第 5～ 15d行动态心电图检查 ,进行ST段改变分析并进行室性早搏的Lown分级和心率变异性时域、频域和非线性分析 ,与非室性早搏者进行对照。结果 :航行中第 6 5～ 75dST段与航前比较明显压低 ,压低持续时间延长 (P <0 0 1) ;航行中第 115～ 12 5d上述改变更明显 (P<0 0 1) ;海勤人员比陆勤人员、机电部门比其他部门、≥ 30岁者比 <30岁者、航龄≥ 10年者比 <10年者压低及其持续时间变化更明显 (P <0 0 1) ;航后第 5～ 15d上述参数又接近于航前 15～ 5d时的水平。与非室性早搏者比较 ,室性早搏者SDNN、SDANN、SDNNindex、RMSSD、NN50 、PNN50 、三角指数、VIF、HLF、VAI及VL1明显降低 ;Lown分级越高 ,上述变化越明显。结论 :长航对参加人员的ST段改变产生了一定程度的影响 ,但部分是可逆的 ;

Objective:To analysis the ST segment and the correlation between ventricular premature beat and heart rate variability during long voyage.Methods:We analyzed the ST segment in Holter and the correlation between ventricular premature beat and heart rate variability in 77 men and 4 women between the 5th and 15th day before voyage,between the 65th and 75th day during the voyage,and between the 115th and 125th day during the voyage,respectively.What's more,in 29 men and 3 women of the 81 subjects the ST segment in Holter and the correlation were examined between ventricular premature beat and heart rate variability between the 5th and 15th day after voyage.Results:The ST segments in Holter were lower in 77 men and 4 women between the 65th and 75th day during the voyage than that between the 5th and 15th day before voyage(p<0.01).The relationship between Lown's degrees of ventricular premature beats and SDNN,SDANN,SDNN index,RMSSD,NN 50,PNN 50,Triangular index,VLF,HLF,VAI and VLI were negative(P<0.01).Conclusion:This study indicates that long voyage may change the ST segment in Holter and cause ventricular premature beat by reducing hear autonomic activity.