不同年龄段老年冠心病患者心率变异性研究

Heart rate variability in elderly patients with coronary heart disease at different age stages

目的 探讨老年冠心病患者在不同年龄段心率变异性（HRV）情况。方法 入选2014年1月至2014年12月住院及门诊体检的老年冠心病患者162例,根据患者年龄分为3组：60~69岁组54人,70~79岁组41人,≥80岁组67人。使用MGY-H12 24 h动态心电分析系统,对入选患者进行连续24 h心电记录,采用配套计算机软件对HRV指标包括时域指标（SDNN、SDANN、SDNN Index、r MSSD、p NN50）及频域指标[总功率（TP）、极低频功率（VLF）、低频功率（LF）、高频功率（HF）]进行分析,并对不同年龄组HRV进行组间比较。结果 60~69岁组、70~79岁组、≥80岁组老年冠心病患者随年龄增长,其时域指标SDNN、SDANN、SDNN Index及频域指标TP、VLF、LF均值呈逐渐降低趋势（P〈0.05）,其中≥80岁组患者SDNN、SDANN与60~69岁组、70~79岁组比较,差异有统计学意义（P〈0.05）;60~69岁组患者TP、VLF、LF与70~79岁组、≥80岁组比较,差异有统计学意义（P〈0.05）。3组患者r MSSD、p NN50及HF水平比较,差异无统计学意义（P〉0.05）。结论 老年冠心病患者随年龄增长,HRV呈现降低趋势。

Objective To investigate the heart rate variability （HRV） in elderly patients with coronary heart disease （CHD） at different age stages. Methods The elderly patients （n=162） were chosen from Jan. 2014 to Dec. 2014, and according to their age, divided into 60-69 group （n=54）, 70-79 group （n=41） and≥80 group （n=67）. All patients were given 24-h electrocardiogram （ECG） records by using MGY-H12 24-h ambulatory ECG analysis system. The time-domain indexes （SDNN, SDANN, SDNN Index, rMSSD and pNN50） and frequency-domain indexes （TP, VLF, LF and HF） of HRV were analyzed by using assort computer software, and compared among groups. Results As age increased, SDNN, SDANN, SDNN Index, TP, VLF and LF decreased gradually in 3 groups （P〈0.05）. The difference in SDNN and SDANN had statistical significance compared between≥80 group and 60-69 group or 70-79 group （P〈0.05）. The difference in TP, VLF and LF had statistical significance compared between 60-69 group and 70-79 group or≥80 group （P〈0.05）. The difference in rMSSD, pNN50 and HF had no statistical significance among 3 groups （P〉0.05）. Conclusion HRV shows a descending trend as age ascending in elderly patients with CHD.