中老年人晨间心率变化规律及临床意义探讨

Clinical Significance of Morning Heart Rate Change in Middle Age and Elderly

对４００例正常中老年人和４００例患各种心脏病中老年患者进行２４小时动态心电图观察。发现其最慢心率（ＨＲｍｉｎ）、最慢一小时平均心率（ＨＲｍｉｎＤ）和最快心率多集中在３：００～９：００。ＨＲｍｉｎＤ几乎均发生在觉醒前一小时内。分析还发现复杂心律失常、缺血型ＳＴ段改变于晨起活动心率加快时增加。在老年疾病组的这种心率晨间变化特点尤其明显（Ｐ＜０．０１）。故认为ＨＲｍｉｎ和ＨＲｍａｘ的反转是引起晨间心、脑卒中的病理、生理因素之一。

Twenty-four hotlrs ambulatlory electro-cardiography was performed in 400 normal subjectsand 400 patients suffered different heart diseases inmiddle age and elderly. It was found that most of theHRmin, HRmax and HRmin D occured during 3～9am, HRmin D almost all occured one hour beforeawakening. All the changes in disease group wasmore obvious than in normal group(P<0.01).How-ever dysrhythlnia and ischernic ST segment depres-sion were increased when HR was decreased.Weconcluded that thereverse of HRmin and HRmaxmight be one of the pathologic , physiologic factors ofmyocardial and cerebral apoplexy during morning。