性别对室性早搏与平均心率相关性的影响

Influence of gender on the correlation between premature ventricular beats and mean heart rate

目的探讨不同性别的非老年人群中,室性早搏(premature ventricular complexes,PVC)与平均心率的相关性以及动态心电图时域特征。方法选取门诊非老年人群中PVC负荷>1%,且无器质性心脏病的样本共110例,分为男性组和女性组。动态心电图检查后,对每个样本每小时的平均心率和PVC行相关性分析,分别归入快心率相关性PVC(F-HR-PVC)、慢心率相关性PVC(S-HR-PVC)和非心率相关性PVC(I-HR-PVC),并对两组之间PVC种类占比和时域参数进行分析。结果男性组中,F-HR-PVC的比例明显高于女性组(60.0%vs.33.3%),I-HR-PVC和S-HR-PVC的比例则低于女性组(分别为24.0%vs.36.7%,16.0%vs.30.0%),通过这两组患者心率变异性(HRV)参数分析发现,男性组中r MSSD(40.64±27.40 vs.27.83±9.31,P=0.020)和pNN50(11.60±9.31 vs.7.17±5.92,P=0.037)高于女性组,且差异有统计学意义,SDNN和SDANN参数在两组之间差异无统计学意义。结论在无器质性心脏病PVC的非老年人群中,男性组的F-HR-PVC比例高于女性组,S-HR-PVC和I-HRPVC的占比则低于女性组,提示该人群男性PVC的临床发作多可能与交感神经张力升高相关,女性则与副交感神经张力及雌激素等多因素相关。

Objective To investigate the correlation between ventricular premature complexes(PVC)and mean heart rate,as well as the frequency domain characteristics of Holter monitor in non-elderly population of different genders.Methods One hundred and ten cases of non-elderly outpatient patients with PVC load of>1%were enrolled and divided into male group and female group.After the Holter examination,the average heart rate per hour of each sample and the correlation analysis of PVC were divided into fast-heart rate correlated PVC(F-HR-PVC),slow heart rate correlated PVC(S-HR-PVC)and independent heart rate correlated PVC(I-HR-PVC),so as to analyze the proportion of PVC types and time domain indexes of heart rate variability(HRV)between the two groups.Results In the male group,the proportion of F-HR-PVC was significantly higher than that of the female group(60.0%vs.33.3%),while the proportion of I-HR-PVC and S-HR-PVC was lower than that of the female group respectively(24.0%vs.36.7%,16.0%vs.30.0%).HRV analysis of the patients in the two groups showed that r MSSD(40.64±27.40 vs.27.83±9.31,P=0.020)and p NN50(11.60±9.31 vs.7.17±5.92,P=0.037)in the male group were higher than that of the female group.The SDNN and SDANN showed no statistical difference between the two groups.Conclusion In the non-elderly population without definite heart disease,the proportion of F-HR-PVC in the male group was higher than that in the female group,and the proportion of S-HR-PVC and I-HR-PVC was lower than that in the female group,suggesting that the clinical incidence of PVC in the male group may be related to the increase of sympathetic nervous tone,and the female group may be related to the sympathetic parasympathetic nervous system and estrogen.