冠心病室性心动过速患者的心率变异性分析

An analysis of heart rate variability in patients with coronary heart disease with ventricular tachycardia.

目的为探讨冠心病(CHD)患者室性心动过速(VT)与心率变异性(HRV)之间的关系。方法对98例CHD患者,根据动态心电图上有无VT,分为VT组(43例)和无VT组(55例),并与20例健康体检者(对照组)进行对照,观察HRV的时域指标和MI。结果①3组之间R-R间期无明显差异(P>0.05);②CHD患者中HRV时域指标SDNN、SDANN、SDNNindex、rMSSD和PNN50均明显低于对照组(P<0.05);③在CHD患者中VT组SDNNindex与无VT组无差异(p>0.05),其余指标VT组明显低于无VT组(P<0.05);④VT组中MI的总发生率(19例,占44.2%)明显高于无VT组(10例,占18.2%)(P<0.05)。结论CHD患者中HRV减低,尤其伴有VT的患者中更为明显,反映了CHD伴VT患者心脏自主神经调节功能失衡,这类患者更易发生心源性猝死。

Objective To observe the relationship between ventricular tachycardia(VT) and heart rate variability(HRV) in the patients with coronary heart disease(CHD). Methods Ninety-eight CHD patients were divided into VT group(43 cases) and no VT group(NVT, 55 cases) based on with and without VT in ambulatory electrocardiogram, and 20 healthy subjects(control group) were compared. To analyse the HRV and MI differences between three group. Results ①R-R interval no significant difference between three group (P>0.05);②SDNN,SDANN,SDNNindex,rMSSD and PNN50 of HRV in the CHD patients were lower than control group(P<0.05);③SDNNindex were no significant difference (P>0.05),other parameter were significant difference between the VT group and NVT group and the CHD patients(P<0.05);④The incidence of MI in the VT group were higher than in the NVT group(P<0.05). Conclusion The imbalance of the autonomic nervous system lead to HRV decrease in the CHD patients,especially in the patients with VT.