冠心病患者与健康成人心率变异功率谱的比较

The comparison of heart rate variability power spectrum between patients with coronary heart disease and healthy volunteers

本研究用心率变异功率谱技术分析冠心病心绞痛及急性心肌梗塞（ＡＭＩ）患者的心脏植物神经活动，并与健康成人比较。结果：（１）正常低龄组心率变异系数（ＣＶ）高于正常高龄组；０．０２～０．１５、０．１５～０．３５及０．３５～０．５０Ｈｚ的频谱功李均显著高于正常高龄组，其中０．１５～０．３５Ｈｚ的成分尤为明显；（２）正常高龄组的ＣＶ，０．３５～０．５０Ｈｚ的频谱功率均显著高于心绞痛组，而０．０２～０．１５Ｈｚ的频谱功率则显著低于心绞痛组，两组之间０．１５～０．３５Ｈｚ的频谱功率无显著差异；（３）ＡＭＩ组ＣＶ显著低于以上各组，０．０２～０．１５及０．３５～０．５０Ｈｚ频谱功率非常显著低于正常高龄组及心绞痛组，０．１５～０．３５Ｈｚ频谱功率显著低于正常高龄组。结果提示：老年人心脏植物神经活动较年轻人减弱，对心率的调节能力下降；心绞痛患者心交感神经张力增强，心迷走神经张力减弱；ＡＭＩ患者心脏植物神经活动均明显减弱，这是否与机体保护性抑制机制有关，有待进一步研究。

The autonomic nervous control of the heart was assessed by measuring the power spectrum of spontaneous heart rate fluctuations in young, elderly healthy volunteers and patients with angina pectoris and with acute myocardial infarction(AMI). The results indicated that the heart rate variability(HRV) in angina and AMI patients was lower than that in young and elderly volunteers. In the patients with AMI, HRV spectral power markedly reduced at all frequencies examined(0. 02～0. 50 Hz). In the patients with angina pectoris,HRV spectral power was markedly increased at low frequency (0. 02～0. 15 Hz) and was markedly reduced at high frequency(0. 35～0. 50 Hz) as compared to elderly healthy volunteers. It is suggested that the reduction in HRV results from the decrease in autonomic modulation of the heart rate in patients with AMI and with angina pectoris. It is also suggested that an increased sympathetic nerve activity appeared in patients with angina pectoris, and a depression of both sympathetic and parasympathetic activity appeared in AMI patients.