自主神经功能测量在评价运动员常见心律失常中的作用

Role of autonomic function test in evaluation of abnormal electrocardiogram in athletes

目的研究自主神经功能测量在评价运动员常见心律失常中的作用。方法 35例运动员分为室性早搏组(A组,8例)、房室传导阻滞组(B组,15例)和重度窦性心动过缓组(C组,12例);另选取21例健康大学生设为对照组(D组)。采用短程心率变异性(HRV)测量方法度量心自主神经功能变化。结果与D组相比,A组ECG正常时正常窦性R-R间期的标准差(SDNN)、相邻N-N间期差值均方根值(RMSSD)、相邻间期差值的标准差(SDSD)、NN50占所有NN间期个数的百分数(PNN50)、标化的高频率范围内的功率(HFnu.)均升高(P<0.05),高频率与低频率范围内的功率之比(LF/HF)及标化的低频率范围内的功率(LFnu.)降低(P<0.05);而ECG出现室性早搏时SDNN、RMSSD、SDSD、总功率(TP)、HF低于ECG正常时(P<0.05)。B组ECG正常时HF、极低频率范围内的功率(VLF)低于D组(P<0.05);而ECG出现房室传导阻滞时TP、HF、LF较ECG正常时升高(P<0.05)。C组ECG正常时HRV各指标与D组相比均无统计学差异;而出现重度窦性心动过缓时VLF较ECG正常时下降(P<0.05),SDNN、RMSSD、SDSD、PNN50及TP、HF均高于D组(P<0.05)。结论 35例运动员ECG变化与其心自主神经功能变化相吻合,可排除器质性心脏病变的可能。

Objective To investigate the role of autonomic function test in the evaluation of abnormal ECG in athletes. Methods Thirty-five athletes were divided into three groups of A（with ventricular premature beat, 8 cases）, B（with atrioventricular block, 15 cases） and C（with serious sinus bradycardia, 12 cases）. Another 21 healthy people were taken as the controls（group D）. The change of cardiac autonomic nervous function was measured by short-term heart rate variability（HRV） test. Results Compared with group D, SDNN, RMSSD, SDSD, PNN50 and HFnu. were increased, while LF/HF and LFntL were decreased during normal ECO in group A（P〈0. 05）. Besides, SDNN, RMSSD, SDSD, TP and HF during abnormal ECG were lower than those during normal ECG in group A（P〈0.05）. HF and VLF were lower during normal ECG in group B than those in group D （P〈0. 05）, and TP, HF and LF during abnormal ECG were higher than those during normal ECG in group B（P〈0. 05）. There was no significant difference in HRV between group C during normal EGG and group D. Compared with group C during abnormal ECG, VLF was increased during normal ECG （P〈0. 05） ,while SDNN,RMSSD,SDSD,PNN50,TP and HF were decreased in group D（P〈0. 05）. Conclusion ECG changes of 35 athletes are consistent with cardiac autonomic nervous function,which excludes the possibility of organic heart diseases.