老年代谢综合征患者心率变异时域指标和频域指标的观察及临床意义

Study on the clinical significance of variability of heart rate about time domain and frequency domain indicators in elderly patients with metabolic syndrome

目的观察老年代谢综合征(MS)患者心率变异(HRV)的时域及频域指标,了解老年代谢综合征对心脏自主神经功能的影响。方法选择120例老年患者行动态心电图检查,做空腹血糖、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、体重、身高、血压检测,计算体重指数(BMI)。将患者分为MS组63例和非MS组57例,分别比较两组HRV时域指标[全程正常窦性R-R间期的标准差(SDNN)、全程记录中每5 min平均RR间期的标准差(SDANNindex)、全程记录中每5 min RR间期标准差的平均值(SDNNindex)、全程相邻RR间期之差的均方根值(r MSSD)、全程内差值超过50 ms的连续正常RR间期所占的百分率(PNN50)]及频域指标[总功率(TP)、高频功率(HFP)、低频功率(LFP)、极低频功率(VLFP)]。结果 MS组的各项时域指标均低于非MS组,差异有统计学意义(P<0.05)。MS组的部分频域指标(TP、VLFP)低于非MS组,差异有统计学意义(P<0.05)。结论老年MS患者HRV时域指标和部分频域指标低于非MS者,MS患者心脏自主神经功能受损,恶性心血管事件发生几率增加。临床上应加强老年MS患者HRV的检测。

Objective To observe the time domain and frequency domain of variability of heart rate in elderly patients with metabolic syndrome,and to understand the impact on cardiac autonomic function in elderly patients with metabolic syndrome. Methods The monitoring of Holter,examination of blood levels of fasting glucose,triglycerides（TG） and high density lipoprotein（ HDL-C）,weight,height,blood pressure testing and body mass index（ BMI） had been carried out in 120 elderly patients. They were divided into MS group（63 cases） and non-MS group（ 57 cases）,patients in these two groups were compared in time domain HRV indices（ SDNN,SDANN index,SDNN index,r MSSD,PNN50） and frequency domain（ TP,LFP,VLFP,HFP）. Results SDNN,SDANN index,SDNN index,r MSSD,PNN50 index in patients of MS group were lower than those of patients in non- MS group,and the difference was statistically significant（ P 〈 0. 05）. TP and VLFP indexes in patients of MS group were lower than those of patients in non- MS group,and the difference was statistically significant（ P 〈 0. 05）. Conclusion HRV time domain and part frequency domain in elderly patients with MS were lower than those of patients in non- MS group,impaired cardiac autonomic function in elderly patients with MS may lead to the increase of adverse cardiovascular events,hence elderly patients with MS should strengthen the detection of HRV.