有极慢心室率患者的心率变异研究

Observing SDNN of Patients Who Have Very Low Heart Rate in HOLTER

目的观察24小时动态心电图中出现极慢心室率（〈40bpm）患者的心率变异指数SDNN。方法动态心电图检查者中,最慢心室率小于40bpm的病例,分为窦律无房颤或房扑组、全程房颤或房扑组（标记为＂窦性＂统计）、窦律伴房颤或房扑组,记录性别、年龄、最慢、最快及平均心室率、最慢心室率性质、最长N-N间期及性质、心率变异指数SDNN。另取同期无极慢心室率的窦律组90例和全程房颤或房扑组102例作对照。SDNN正常值为文献提供的参考值。结果平均SDNN在极慢心室率窦律组为200.5±57.1ms,平均年龄男性组明显低于女性组（p〈0.05）;极慢心室率房颤或房扑组为232.2±39.6ms,平均年龄男性组明显低于女性组（p〈0.001）;无极慢心室率窦律组为103.0±39.7ms,平均年龄男性组与女性组无明显差异;无极慢心室率房颤或房扑组为151.8±42.5ms,平均年龄男性组明显低于女性组（p〈0.05）。有极慢心室率的各组均明显高于正常参考值（p〈0.001~0.05）;无极慢心室率的窦律组明显低于正常参考值（p〈0.001）;无极慢心室率的房颤或房扑组的全组和男性组明显高于正常参考值（p〈0.05）。结论常见病患者中,平均SDNN在有极慢心室率各组均明显高于无极慢心室率的各组,男性出现极慢心室率的平均年龄明显早于女性;有极慢心室率的各组和无极慢心室率的房颤或房扑组的全组和男性组均明显高于正常参考值,无极慢心室率的窦律组明显低于正常参考值。

Objective To observe SDNN of patients who have very low heart rate（40bpm）in Holter.Methods Choose patients who have very low heart rate（40bpm）in Holter.Divide them into 3 groups： sinus rhythm without atrial flutter or fibrillation group,atrial flutter or fibrillation group（mark them as ＂sinus rhythm＂ to calculate）,sinus rhythm with atrial flutter or fibrillation group.Record their gender,age,the lowest heart rate,the highest heart rate,mean heart rate,the longest N-N intermissions,SDNNs.Choose 90 cases of sinus rhythm without atrial flutter or fibrillation group 102 cases of atrial flutter or fibrillation group without very low heart rate to compare with.Consult the reference value of SDNN from ESC NASPE in 1996.Results In those having very low heart rate groups,the mean SDNN of sinus rhythm without atrial flutter or fibrillation group is 200.5±57.1ms,the mean age of males is significantly lower than females（p〈0.05）,atrial flutter or fibrillation group is 232.2±39.6ms,the mean age of males is significantly lower than females（p〈0.001）.In those without very low heart rate groups,the mean SDNN of sinus rhythm without atrial flutter or fibrillation group is 103.0 ±39.7ms,the mean age of males females is not significantly different,atrial flutter or fibrillation group is 151.8±42.5ms,the mean age of males is significantly lower than females（p〈0.05）.The mean SDNNs in those having very low heart rate groups atrial flutter or fibrillation group without very low heart rate are all higher than the normal reference value（p〈0.001~0.05）,but in sinus rhythm without atrial flutter or fibrillation group without very low heart rate is significantly lower than the normal reference value（p〈0.001）.Conclusions In common patients,the mean SDNNs of those having very low heart rate are significantly higher than those without very low heart rate,the mean age of males who have very low heart rate is significantly lower than females.The mean SDNNs in those having very low heart rate groups atrial flutter or fibrillation group without very low heart rate are all higher than the normal reference value,but in sinus rhythm without atrial flutter or fibrillation groups without very low heart rate are significantly lower than the normal reference value.