心脏病室性心律失常患者自主神经功能与临床相关因素研究

Study on the automatic nervous functions and their clinical correlation factors in patients with cardiac diseases complicated with ventricular arrhythmia

目的 探讨心律失常患者自主神经功能活动与临床诸因素的相关性。方法 分析 5 5例心脏病心律失常患者与 30例无心律失常的心脏病患者的心率变异性及临床相关指标。结果 (1)心律失常组与无心律失常组比较 ,年龄、性别、RV、E/ F比值无显著差异 (均 P>0 .0 5 ) ,平均心率、心功能分级、L Vd、 L Vs、 L VPW、IVS及 EF存在显著差异 (P<0 .0 5～ 0 .0 1)。 (2 )与无心律失常组比较 ,心律失常组除 SDNNindex、SDANN外 ,SDNN、RMSSD、PNN50 及 HRVTI显著降低 (P<0 .0 5～ 0 .0 1)。 (3)心律失常组 SDNN及 HRVTI降低与 L Vd、L Vs、L VPW、IVS、心功能分级及平均心率呈负相关 (P<0 .0 5～ 0 .0 0 1) ,与 EF呈正相关 (P<0 .0 0 1)。结论 心脏病高危室性心律失常患者存在严重的自主神经功能受损和失衡 ,且与心力衰竭。

Objective To inquire into the coherencies between automatic nervous functional activities and their corresponding clinical factors. Methods 55 cases of cardiac disease with arrhythmia and 30 cases without arrhythmia were collected, and their heart rate variabilities and correlative clinical indexes were analyzed. Results (1)there were no significant differences in the age, sex, RV and E/A between the arrhythmia group and non-arrhythmia group(P>0.05), but the differences were significant in average heart rate, cardiac functional grading, LVd, LVs, LVPW, IVS and EF(P<0.05～0.01). (2)Except for the SDNN index, SDANN,the SDNN, RMSSD, PNN 50 and HRVTI decreased remarkably in the arrhythmia group (P<0.05～0.01). (3)In the arrhythmia group, the decrease of SDNN and HRVTI presented a negative correlation with the LVd, LVs, LVPW, IVS, cardiac functional grading and average heart rate (P<0.05～0.01), but positive correlation with the EF (P<0.001). Conclusion There were severe injuries and imbalances of automatic nervous function in patients with heart diseases complicated with high risk ventricular arrhythmia, and they were closely correlative with the degrees of heart failure, left ventricular hypertrophy, hypofunction of left ventricular contraction.