70例持续性房颤患者心率变异性临床分析

The clinical analysis of heart rhythm variance in 70 patients with persistent atrial fibrillation

目的 探讨持续性房颤患者心率变异性（HRV）变化,分析其在基础心脏疾病伴房颤疾病中的临床意义.方法 70例持续性心房颤动患者作为房颤组,70例为正常对照组.行24h动态心电图检查,检测心率变异性时域指标.进一步将70例房颤患者分为孤立性房颤10例,冠心病伴房颤21例,高血压性心脏病伴房颤25例,心衰伴房颤14例.所有房颤患者均进行24h动态心电图监测,观察24h HRV时域分析指标.结果 房颤患者HRV时域分析较正常对照组下降（P＜0.01）.冠心病、高血压性心脏病、慢性心衰伴房颤患者HRV时域分析指标较孤立性房颤患者明显降低（P＜0.01）.结论 冠心病、高血压性心脏病、慢性心衰、伴房颤患者HRV降低,即自主神经对心脏的调节能力减弱.HRV可作为冠心病、高血压性心脏病、心衰伴房颤患者的无创性预测指标.

Objective To explore the heart rate variability of the persistent atrial fibrillation in pa- tients with heart disease and analyze of the basis of atrial fibrillation associated with diseases and its clinical significance. Methods Study on 70 cases of persistent atrial fibrillation patients as atrial fibrillation group and 70 cases of normal control group. All of research cases were detected the time domain of heart rate vari- ability index with 24 hours of dynamic electrocardiogram. 70 cases of atrial fibrillation patients were divided into isolated atrial fibrillation 10 cases, coronary heart disease with atrial fibrillation 21 cases, hypertensive heart disease with atrial fibrillation 25 cases, congestive heart failure 14 cases. All atrial fibrillation objects were observed in 24 h HRV analysis in time domain indexes. Results The HRV time domain analysis of atrial fibrillation patients significantly decreased than in the normal control group（P〈0.01）. Time-domain anal- ysis indexes SDNN and SDANN of HRV coronary heart disease, hypertensive heart disease, chronic heart failure patients with atrial fibrillation significantly decreased than those of patients with isolated atrial fibrilla- tion （P〈0.01）. Conclusion HRV in coronary heart disease, hypertensive heart disease, chronic heart fail- ure, patients with atrial fibrillation decreased, which may indicate the capacity of autonomic nervous system regulation on heart diminished. HRV may be used as noninvasive prediction index in coronary heart disease, hypertensive heart disease, chronic heart failure patients with atrial fibrillation.