绝经前后健康女性的心率减速力分析

Analysis of deceleration capacity in healthy females before and after menopause

目的通过分析围绝经期及老年健康女性心率减速力（ deceleration c a p a c ity , D C ） 的变化,探讨绝经前后女性D C 与年龄、昼夜节律的关系及其对心率的影响.方法将2 3 9 例健康女性按年龄分成两组围绝经期组（4 5 -5 5 岁,1 1 5 例）和老年组（5 6 -7 0 岁,1 2 4 例）.对两组女性行2 4 h 动态心电图检查,计算机自动测定受试者2 4 h 及白天（1 5 ： 0 0 - 2 0 ： 0 0 ） 和夜间（ 0 0 ： 0 0 - 05 ： 0 0 ） 的 D C 、心率加速力（ acceleration c a p a c ity , AC ）值并进行心率变异性（ heartrate v a riab ility,H R V ）分析.结果绝经后,女性2 4 h 的D C 、A C 绝对值及H R V 时域指标S D N N 和r M S S D 均呈下降趋势;两组女性夜间D C 、A C 的绝对值及r M S S D 值均显著高于白天,夜间S D N N 值显著低于白天;绝经后A C 与平均心率的相关系数大于D C 与平均心率的相关系数.结论D C 、A C 与H R V 检测联合应用能预警绝经前后女性各种心血管疾病和降低心源性猝死的风险.

Objective By analyzing the changes of deceleration capacity( DC) of healthy perimenopausal females and elderly women,to investigate the correlationship between DC and age,circadian rhythm,and the impact of DC on heart rate. Methods According to age,239 healthy females were divided into two groups: peri-menopause group( 45- 55 years old,115 cases) and the elderly group( 56- 70 years old,124 cases). They underwent the examination of 24-hour ambulatory electrocardiography and were calculated DC and acceleration capacity( AC) values within 24 hours,in the day of 15 ∶ 00- 20 ∶ 00 and during the night of 00 ∶ 00- 05 ∶ 00 automatically by computer,and made heart rate variability( HRV) analysis. Results For females after menopause,DC value,the absolute value of AC and values of HRV time domain indices of SDNN and r MSSD within24 hours all tended to decrease. At night,DC value,the absolute value of AC and r MSSD value of females in the two groups were all significantly higher than those in the daytime while SDNN valuewas lower. The correlation coefficient between AC and the average heart rate in post-menopausal women was greater than that between DC and the average heart rate. Conclusion A combination of DC,AC and HRV detection technologies helps in making early warning of various cardiovascular diseases and reducing the risk of sudden cardiac death for pre- and post-menopausal females.