有极慢心室率患者的心率变异与甲状腺功能

Relationship of SDNN in Patients Who Have Very Low Heart Rate in HOLTER & Their Thyroid Function

目的研究住院患者24h动态心电图中出现极慢心室率(<40bpm)的心率变异指数SDNN与血甲状腺指标的关系。方法住院动态心电图检查者中,最慢心室率小于40bpm,主导节律为窦律无房颤或房扑的病例,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,血甲状腺指标T3、T4、FT3、FT4、TSH,取同期住院无极慢心室率的窦律患者对照,做t检验和双变量的相关性检验。SDNN正常值为文献提供的参考值141±39ms。结果平均SDNN在有极慢心室率组男性为170.1±58.6 ms,女性为177.7±50.3 ms,无极慢心室率组男性为92.7±38.9 ms;女性为86.2±32.6 ms;平均年龄男性组与女性组无明显差异。有极慢心室率的各组均明显高于正常参考值(p<0.001);无极慢心室率的窦律组明显低于正常参考值(p<0.001);有极慢心室率的各组均明显高于无极慢心室率组(p<0.001)。各组甲状腺指标T3、T4、FT3、FT4、TSH与年龄大多显示出了明显的相关性,与SDNN均未见明显相关性。结论在社区中老年常见病住院患者中,平均SDNN在有极慢心室率组明显高于无极慢心室率组,有极慢心室率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。各组甲状腺指标T3、T4、FT3、FT4、TSH与年龄大多显示出了明显的相关性,与SDNN均未见明显相关性。

Objective Study the relationship of SDNN in patients who have very low heart rate in HOLTER ＆their thyroid function in hospital. Methods Choose patients who have very low heart rate（〈40 bpm） in Holter without atrial flutter or fibrillation. Record their gender, age, the lowest heart rate, the highest heart rate, mean heart rate, the longest N-N intermissions, SDNNs, ＆ their blood thyroid function indexes T3, T4, FT3, FT4, TSH. Choose some patients without very low heart rate in hospital to compare with. Consult the reference value of SDNN was141 ±39 ms. Results In those having very low heart rate groups, the mean SDNN of males is 170.1 ±58.6 ms,females is 177.7 ±50.3 ms. In those without very low heart rate groups, the mean SDNN of males is 92.7 ±38.9 ms, females is 86.2±32.6 ms. The mean SDNNs in those having very low heart rate groups are significantly higher than the normal reference value（ p〈0.001）, in those without very low heart rate are significantly lower than the normal reference value（ p〈0.001）. Their blood indexes of thyroid function show high relations to their age, but no significant relations to their SDNNs. Conclusions Patients in hospital from communities, the mean SDNNs in those having very low heart rate groups are higher than the normal reference value, in those without very low heart rate are significantly lower than the normal reference value. Their blood indexes of thyroid function show high relations to their age, but no significant relations to their SDNNs.