老年人心脏自主神经功能变化的临床研究

Clinical Study on the Variation of CAN Function of the Aged

目的 了解老年人心脏自主神经 (CAN)功能的变化及临床意义。方法 对 4 0例老年人离退休及疗养员健康查体采用美国DMS公司 2 4h动态心电图 (DCG) 6 0Gold软件进行线性及非线性分析方法 ,心率变异 (HRV)数据来评价心脏自主神经功能状态。结果 心率变异 (HRV)的时域指标 :SDNN 1 0 5 .2± 30 .1 ;SDANNindex 1 1 2 .4± 2 9.2 ;SDNNin dex 4 6 .7± 1 4 .5 ;rMSSD 2 4 .6± 1 3.1 ;PNN50 4 .6 5± 6 .8;频域指标 :TP 2 378.9± 1 2 77;VLP1 4 6 .0± 82 1 .1 ;LF 34 0 .6±2 0 7.6 ;HF 1 0 6 .9± 1 38.8;LF/HF 2 .8± 1 .8均有不同程度的异常改变 ,非线性指标有全部心率庞加莱散点绘图A ,D象限中散点浓密 6 0 .86± 1 .72 ;B ,C象限 39.5 7± 6 .94 ;A ,D >B ,C象限。全部心率庞加莱差值散点图 :彗星状 2 1例( 5 2 .5 % ) ;鱼雷状 5例、不成形状 2例、扇状 3例、短棒状 9例等均为异常图 ( 4 7 5 % )。

Objective Comprehend the variation and clinical significance of cardias autonomic function (CAN) function of the aged. Methods Using 24 h dynamic EDG of American DMS Company with 6.0 Gold software, we made linear analysis and nonlinear analysis on 40 cases, which were composed of retired old people and convalescents in our sanatorium. It can be assessed on their CAN function from the Heart Rate Variability (HRV) data of 40 cases. Results Both the time domain marks of HRV: SDNN 105.2±30.1; SDANNindex 112.4±29.2; SDNNindex 46.7±14.5; rMSSD 24.6±13.1; PNN 504.65±6.8 and the frequency domain marks: TP 2 378.9±1 277; VLP 146.0±821.1; LF 340.6±207.6; HF 106±138.8; LF/HF: 2.8±1.8 have various abnormal changes. Nonlinear marks: from the poincare plots on all cardiac rates, the density of scatter points in A, D quadrants is 60.86±1.72 as well as 39.57±6.94 in B, C quadrants, that is, A, D>B, C. Among the modifed poincare plots on all cardiac rates, there are 21 cases in normal comet shape (52.5%), and the rest are abnormal cases (47.5%) such as 5 torpedo shapes, 2 complex shapes, 3 fan shapes, 9 short bar shapes. Conclusion CAN function of the aged has descended to some extent.