扩张性心肌病患儿心率变异性的预后意义

Prognostic significance of heart rate variability in children with dilated cardiomyopathy

目的探讨扩张性心肌病(DCM)患儿心率变异性(HRV)变化的预后意义。方法收集42例扩张性心肌病患儿,分成A组心功能Ⅰ～Ⅱ级(NYHA分级,n=20)和B组心功能Ⅲ～Ⅳ级(n=22),以及健康儿童对照组(n=20);采用Mars3000动态心电图仪常规记录24h动态心电图,分析HRV时域参数(SDNN、SDANN、PNN50和rMSSD)和频域参数(TF、VLF、LF、HF、LF/HF)。结果(1)DCM患儿(A组与B组)与对照组比较,各参数差异均有统计学意义(P<0.01);(2)DCM患儿共死亡16例,存活26例,死亡组与存活组各参数比较,t检验有统计学意义。结论HRV可作为评估DCM患儿病情程度的指标,并可作为预后的预测因子。

Objective To estimate the prognostic significance of abnormal heart rate variability (HRV)in children with dilated cardiomyopathy(DCM).Method Forty-two children with DCM were divided into group A with cardiac function of (NYHA)class Ⅰ~Ⅱ(n=20)and group B with cardiac function of class Ⅲ~Ⅳ(n=22).HRV parameters of twenty healthy children served as the control group were measured by Mars 3000 Holter monitoring including time domain parameters such as SDNN、SDANN、PNN50、rMSSD and frequency domain parameters such as TP、VLF、LF、HF and LF/HF.Results (1)There were significant differences in HRV parameters among the group A、group B and the control group with analysis of variance(p<0.01),and a statistical significance between any two groups in any HRV parameter(p<0.01);(2)There were 16 children with DCM died,26 cases survived.There was a significant difference in HRV between the death group and the survival group.Conclusion HRV may have a clinical compliance on the prognisis of DCM children.