心率减速力对扩张型心肌病心力衰竭患者的猝死预警研究

Alert value of deceleration capacity of heart rate for sudden death in patients with dilated cardiomyopathy and heart failure

目的 探讨心率减速力值对扩张型心肌病心力衰竭患者的猝死预警作用.方法 应用24h动态心电图连续记录35例扩张型心肌病（DCM）心力衰竭患者和40名健康者（对照组）的心率减速力（DC）值和心率加速力值,并进行1年内的猝死预警分析.结果 35例DCM心力衰竭患者DC值≥4.5 ms,1年内死亡率为5.71％,DC值2.6～4.4 ms死亡率为20.00％,DC值≤2.5 ms死亡率为34.28％,DC值≥4.5 ms的患者与DC值2.6～4.4 ms和≤2.5 ms者比较差异有统计学意义（P＜0.01）;40名健康人（对照组）心率减速力各值中无死亡病例.心率加速力值≤-7.0 ms,除扩张型心肌病心力衰竭组1年死亡率为2.85％外,余均无死亡.结论 心率减速力值测定能定量、单独分析和测定迷走神经作用的强度,对扩张型心肌病心力衰竭高危人群筛选与猝死预警具有较强的实用价值.

Objective To study the prewarning sudden death value of deceleration capacity of rate to dilated cardiomyopathy （DCM） heart failure patients.Methods The deceleration capacity of rate and acceleration capacity of rate were recorded with 24 hour dynamic electrocardiogram in 35 patients with dilated cardiomyopathy heart failure （dilated cardiomyopathy group） and the 40 cases of healthy people （healthy people group）.The the one-year fatality and prewarning analysis were analyzed Results The one-year fatality was 5.71％ when deceleration capacity of heart rate value was larger than 4.5 ms,20.00％ between 2.6 and 4.4 ms,and 34.28％ when smaller than 2.5 ms,which showed significant differences （P＜0.01） in the patients with dilated cardiomyopathy heart failure.No death occurred in healthy people.Acceleration capacity of heart rate value was smaller than-7.0 ms.The one-year fatality rate of the dilated cardiomyopathy heart failure was 2.85％.Conclusion The deceleration capacity of heart rate value can be used to quantitate,analyze and determine the intensity of vagus nerve effect.It has practical value in prewarning and screening the high-risk dilated cardiomyopathy heart failure.