冠心病患者心率震荡与静息心率的相关性研究

To study the correlation between heart rate turbulence and resting heart rate in the patients with coronary heart disease.

目的研究心率震荡(HRT)和静息心率(RHR)、心率变异性时阈指标(SDNN)在冠心病(CHD)中的变化,以及它们之间的关系。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(良性室性心律失常组:偶发室早)32例,B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,动态心电图记录SDNN和6am的静息心率(RHR),计算心率震荡的两个参数:震荡初始(TO)和震荡斜率(TS),比较两组间的差别,分析TO、TS与SDNN、RHR之间的相关性。结果B组TO值高于A组(0.80%±3.94%vs-1.45%±4.37%,p<0.05),而TS值低于A组(11.03±11.01ms/RR间期vs19.77±19.00ms/RR间期,p<0.05),RHR值明显高于A组(82.18±9.70bpmvs70.94±11.32bpm,p<0.01),B组TO与SDNN呈负相关,与静息心率呈正相关;TS与静息心率呈负相关,而与SDNN无明显相关。结论冠心病患者伴有不良室性心律失常时,心率震荡现象减弱,心率震荡增加,提示心脏自主神经平衡的破坏与不良性室性心律失常有一定的内在联系。

Objective To study the change of the heart rate turbulence （HRT） and resting heart rate（RHR）, standard deviation of normal-to-normal RR interals（SDNN） in the coronary heart disease（CHD） ,and to research the relationship between them. Methods Fity-three patients with CHD were investigated, they were divided into two groups according to the Holter record. Thirty-two patients in A group（the group of benign ventricular arrythmias： occasional premature ventricular contraction）, and twenty-one subjects in B group（the group of non-benign ventricular arrythmias： paroxysmal ventricular tachycardia or muti-source or frequent ventricular premature beats）, Holter recorded the SDNN and the HRT of 6Am, HRT onset and slope were measured by the original definitions using Holter records and its relevance with SDNN,RHR was analysed. Results The value of the HRT onset of B 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 A group （11.03＋11.01ms/RR interval vs 19.77±19.00ms/RR interval,p〈0.05 ）, the value of RHR was significantly higher than that of A group （82.18±9.70bpm vs 70.94±11.32 bpm,p〈0.01）. There was significant negative correlation between TO and SDNN in B group, and positive correlation between TO and RHR.There was negative correlation between TS and RHR,and no correlation between TS with SDNN. Con- clustion If the patients with CHD have non-benign ventricular arrythmias, HRT dramatically blunted and RHR increased. Our study indicated that the damaged autonomic nerve function of heart may correlate with non-benign ventricular arrhythmias.