老年冠心病69例心率震荡分析及临床意义探讨

Analysis of heart rate turbulence in senile coronary heart disease and its clinical significance in 69 cases

目的:探讨老年冠心病患者心率震荡(HRT)的变化及临床意义。方法:选择有室性早搏的老年冠心病患者69例,和排除器质性心脏疾病的老年对照组75例,行24h动态心电图监测,计算HRT的两个指标震荡初始(TO)和震荡斜率(TS)。比较两组的TO及TS值;并根据HRT分级的不同对老年冠心病患者因心脏性原因死亡的情况进行为期3年的随访。结果:老年冠心病组TO(2.13±3.11)%高于对照组(-1.85±2.01)%,TS(2.33±1.19)ms/RR低于对照组(9.72±3.53)ms/RR,差异均有显著意义(P<0.05)。随访36个月,老年冠心病患者中2个指标均异常者(HRT2级)因心脏性原因病死率最高。结论:老年冠心病患者存在HRT异常。其异常程度与患者的心脏性死亡情况密切相关,HRT可作为冠心病临床上判断预后的重要心电指标。

Objective：To investigate the change of heart rate turbulence（HRT）in senile coronary heart disease（CHD）and its clinical significance.Methods：69 patients with senile CHD complicating ventricular premature beats（VPB）and 75 elderly patients excluded organic heart diseases as the control group were performed 24h dynamic electrocardiogram monitoring.Turbulence onset（TO）and turbulence slope（TS）were calculated and compared between the two groups.Results：TO was（2.13±3.11）%in senile CHD group and（-1.85±2.01）% in the control group,the former was significantly higher than the latter.TS was（2.33±1.19）%in senile CHD group,which was lower than （9.72±3.53）%in the control group with significant difference（P〈0.05）.Follow up lasted for 36 months.The patients with both two abnormal indexes（grade 2 HRT）had highest fatality caused by cardiac causes.Conclusion：HRT exists in the patients with senile CHD,its abnormal degree is closely related with cardiac death.Therefore,HRT may be an important electrocardiogram index for judging prognosis of CHD in clinic.