应用全导联可穿戴式动态心电监护设备观察高强度体能训练的心率变异性

Observation of heart rate variability in physical training with Holter monitoring suits

目的应用新型可穿戴式全导联动态心电监护设备观察高强度体能训练前后的心律失常及心率变异性变化。方法入选2019年10月至2020年6月在石家庄联勤保障部队第九八〇医院保障系统内部某训练基地受试者144例,其中男105例,女39例,年龄(35.1±3.5)岁,连续穿戴动态心电监护衣48 h并在此期间进行高强度体能训练,采用自身对照法比较训练前后的心律失常发生率和心率变异性指标,包括正常RR间期标准差(SDNN)、每5 min RR间期均值标准差(SDANN)、SDANN指数和相邻正常RR间期差值均方根值(RMSSD)、低频、高频及超低频等。结果共计131例受试者完成全程动态心电图监护分析,平均总监护记录时间(43.87±2.09)h。训练前总的心律失常发生率20.6%(27/131),室性早搏发生率4.6%(6/131),房性早搏发生率9.9%(13/131),训练后有19.1%(25/131)仍存在心律失常,仍有室性早搏3.8%(5/131),房性早搏8.4%(11/131),未见ST-T改变,无新发心律失常。体能训练阶段的心律失常发生率较非高强度训练时间段差异无统计学意义(P=0.640)。训练后平均心率、最大心率均高于训练前[(74.66±9.91)次/min对(71.45±7.42)次/min,P=0.003][(144.86±23.55)次/min对(131.75±15.14)次/min,P<0.001]。SDNN、SDANN、SDANN指数和RMSSD均高于训练前日常工作状态,差异有统计学意义(P<0.05)。结论应用可穿戴式全导联动态心电监护观察到高强度体能训练对心律失常影响不大,但可增加心率变异性,改善心脏自主神经的调节功能。

Objective To observe arrhythmia and heart rate variability around physical training using a new wearable full-lead Holter monitoring suit.Methods From October 2019 to June 2020,144 subjects were selected in a training base within the support system of the 980 st Hospital of Joint Logistics Support Force in Shijiazhuang,including 105 males and 39 females,with an average age of(35.1±3.5)years old.They continuously wear the Holter monitoring suit for 48 hours and performed high-intensity physical training during this period.Self-control method was used to compare the incidence of arrhythmia and heart rate variability before and after training,including standard deviation of normal RR interval(SDNN),standard deviation of mean RR interval every 5 min(SDANN),SDANN index and adjacent normal RR interval Root mean square difference(RMSSD),low frequency,high frequency and ultra-low frequency.Results A total of 131 cases completed the whole-course Holter monitoring and analysis,with an average recording time of(43.87±2.09)h.The total incidence of arrhythmia was 20.6%(27/131)before training,the incidence of premature ventricular beats was 4.6%(6/131),and the incidence of atrial premature beats was 9.9%(13/131).After training,19.1%(25/131)still had arrhythmias,there were still ventricular premature beats 3.8%(5/131),atrial premature beats 8.4%(11/131).No ST-T changes and new arrhythmias were observed.Compared with the non-high-intensity training period,there was no significant changes in the incidence of arrhythmia during physical training(P=0.021).The average heart rate,total heart rate,and maximum heart rate after training were higher than that before training[respectively(74.66±9.91)bpm vs.(71.45±7.42)bpm,P=0.003;(144.86±23.55)bpm vs.(131.75±15.14)bpm,P<0.001].The SDNN,SDANN,SDNN index and RMSSD were higher than that the normal working state before training(P<0.05).Conclusion Holter monitoring suits can be used for physical training in batches.Conventional physical training has little effect on arrhythmia,but increases the heart rate variability,and improves the regulation of heart autonomic nervous system.