冠心病患者窦性心率震荡与心率变异性的研究

To study the correlation between heart rate turbuence and heart rate variability in the patients of coronary heart disease with ventricular arrhymias

目的对冠心病患者窦性心率震荡(HRT)和心率变异性(HRV)时域指标进行分析,探讨其变化机制和临床意义。方法选择有室性早搏的冠心病患者53例,根据24h动态心电图(Holter)记录资料分组,A组(不良室性心律失常组:伴有阵发性室性心动过速或多源性室早或频发室早)21例,B组(良性室性心律失常组:偶发室早)32例,Holter记录心率变异性(HRV)的时域指标,计算HRT的两个参数:震荡初始(TO)和震荡斜率(TS),比较两组间的差别。结果A组TO值高B组(0.80%±3.94%vs-1.45%±4.37%,P<0.05),而TS值低于B组(11.03±11.01ms/RR间期vs19.78±19.00ms/RR间期,P<0.05)。A组HRV各时域指标均明显小于B组。结论冠心病患者伴有不良室性心律失常时,HRT现象变钝,说明HRT对预测有不良性室性心率失常的患者的危险性具有临床价值,HRV各时域指标降低,表明HRV下降与不良性室性心律失常有关,HRT可弥补HRV对预后评估的准确性。

Objective To analyze the heart rate turbulence（HRT） and heart rate variability （HRV） in the coronary heart disease（CHD）, and to research their variable mechanism and clinic meaning.Methods Fity-three patients with CHD were investigated,they were divided into two groups according to the Hoher record.Twenty-one patients in A group （the group of non-benign ventricular arrythmias： paroxysmal ventricular tachycardia or muti-source or frequent ventrieular premature beats ）,and thirty-two subjects in B group（the group of benign ventricular arrythmias： occasional premature ventricular contraction）,Holter recorded the HRV,HRT onset and slope were measured by the original definitions using Hoher records and the compare the difference between the two groups.Results The value of the HRT onset of A group was significantly higher than that of A group （0.80%±3.94%vs-1.45%±4.37% ,P〈0.05） ,the value of TS was lower than that of B group（ 11.03±11,01ms/RR interval vs19.77±19.00ms/RR interval ,P〈0.05 ） ,the values of HRV was significantly lower than that of B group.Conclusion If patients with CHD have non-benign ventricular arrythmias,HRT is dramatically blunted.That means HRT may be a predict factor of risk for the patients of CHD with non-benign ventricular arrythmias. The values of HRV are lower, that indicates lower HRV related with non-benign ventricular arrythmias.HRT may make up the accuracy of HRV to estimate the prognosis.