冠心病患者窦性心率震荡的研究

Study of the change and significance of heart rate turbulence in patients with coronary artery disease

目的探讨冠心病伴室性早搏患者窦性心率震荡(HRT)的变化及意义。方法选择伴室性早搏的冠心病患者和无器质性心脏病的室性早搏患者各30例,记录24h动态心电图,计算其震荡起始(TO)和震荡斜率(TS)。结果冠心病组震荡起始明显高于对照组(0.05±0.58%vs-2.22±1.01%,p<0.001),震荡斜率明显低于对照组(5.89±2.65ms/RRvs7.36±1.34ms/RR,p<0.01)。冠心病患者的震荡起始(TO)与左室射血分数(LVEF)负相关(r=-0.3473,p>0.05),与冠脉病变支数正相关(r=0.5669,p<0.01);震荡斜率(TS)与左室射血分数(LVEF)正相关(r=0.6406,p<0.001),与冠脉病变支数负相关(r=-0.6989,p<0.01)。结论冠心病患者窦性心率震荡(HRT)减低,故窦性心率震荡可用于冠心病患者病情程度的判断。

Objective To study the change and significance of heart rate turbulence in patients with coronary artery disease （CAD）. Methods 30 of CAD patients and 30 structurally normal patients with ventricular premature contraction were included. HRT were analysed by 24-hour Hoher recordings.Results TO in CAD patients were higher than the control group（0.05±0.58% vs - 2.22±1.01%,p〈0.001 ）, while TS were lower than in the latter （5.89±2.65 ms/RR vs 7.36±1.34 ms/RR,p〈0.01）.TO were negtively correlated with left ventricular ejection fraction （LVEF） （r=-0.3473, p〉0.05）, and positively correlated with the number of abnormal coronary artery （r= 0.5669,p〈0.01）; TS were positively correlated with LVEF （r=0.6406, p〈0.001）,and negtively correlated with the number of abnormal coronary artery （r= - 0.6989, p〈0.01）. Conclusions HRT variables are impaired in patients with CAD.HRT might be used as a novel index for the determination of severity of CAD.