特发性右室流出道室早患者心率减速力与心率变异性分析

Deceleration capacity of heart rate and heart rate variability in idiopathic right ventricular outflow tract premature beat patients

目的本研究拟通过分析特发性右室流出道室早患者的24小时动态心电图的心率减速力(deceleration capacity of heart rate,DC)、心率加速力(aceleration capacity heart rate,AC)、连续的心率减速力(heart rate deceleration runs,DRs)及心率变异性各项指标,探讨特发性右室流出道室早的发生与自主神经功能的相关性,及DC、DRs等新技术指标在此类型心律失常中的应用价值。方法连续入选我院符合研究标准的45例特发性右室流出道室早患者和45例作为正常对照的健康人群,根据24小时动态心电图检查数据,比较两组间DC、AC、DRs及心率变异性各项指标包括时域指标:RR总体标准差(SDNN)、24小时每5分钟RR间期平均值的标准差(SDANN)、相邻RR间期差值的均方根值(RMSSD)、相邻RR间期差值>50 ms的百分数(pNN50);频域指标:低频功率(LF)、高频功率(HF)及两者的比值(LF/HF)分析两组间各指标的差异。结果两组间的LF/HF值存在统计学差异(P<0.05),但其他心率变异性指标的差异均无显著性(P>0.05);两组间DC、AC、DR1、DR8、DR10的差异无显著性(P>0.05),但从DR2起直到DR7,及DR9均存在统计学差异(P均<0.05)。结论特发性右室流出道室早患者自主神经功能受损,且以迷走功能减退为主。

Objective： To investigate the correlation between idiopathic right ventrieular outflow tract ventricular prema- ture beat （ RVOT-VPB ） and autonomic nervous system by analyzing the deceleration capacity of heart rate （ DC ）, the accel- eration capacity of heart rate （AC）, the heart rate deceleration runs（DRs） and the indexes of heart rate variability（HRV） in RVOT-VPB patients. Methods： Twenty-four h ECG Holter monitorlngs were carried out in consecutive 45 RVOT-VPB patients and 45 healthy control. DC, AC, DRs and HRV, including SDNN, SDANN, RMSSD, pNN50, LF, HF and LF/ HF were compared. Results： The indexes of HRV were not different between the two groups （P 〉 O. 05 ） except LF/HF（P 〈0. 05）, DC, AC, DR1, DR8 and DR10 were not significantly different between two groups. However, DR2-7 and DR9 were lower in RVOT-VPB group than in the controlled group （ P 〈 0. 05 ）. Conclusion： Autonomic nervous system func- tions, especially vagal nerve system function, are impaired in RVOT-VPB patients.