128例产褥期妇女心电图异常与心率变异性异常的关系分析

Analysis of relationship between abnormal ECG and abnormal heart rate variability in 128 puerperal women

目的探讨产褥期妇女心电图异常的发生情况及其与心率变异性(HRV)异常的关系。方法选取分娩的128例产褥期妇女为研究对象,进行心电图检查及5min的短程心率变异性检测;根据心电图结果分为观察组(心电图异常)及对照组(心电图正常),短程心率变异性检测主要包括RR间期标准差(SDNN)、低频功率(LF)、高频功率(HF)、总功率(TF)、低频功率与高频功率比值(LF/HF)。结果128例产褥期妇女的心电图中,异常心电图者39例,异常率为30.5%,其中窦性心律失常15例(包括窦性心动过速、窦性心动过缓、窦性心律不齐、窦房结内游走心律等),ST-T改变11例,房性早搏1例,室性早搏1例,短P-R间期3例,心室预激1例,右束支传导阻滞1例,胸导联低电压1例,QRS波电交替1例,兼具两项以上异常者4例。心电图异常的观察组39例,心电图正常的对照组89例。观察组有HRV异常者11例,异常率为28.2%。观察组SDNN、LF、HF、TF降低的发生率均较对照组明显增高,差异具有统计学意义(P<0.05)。结论产褥期妇女的异常心电图发生率高,心电图异常的发生与HRV降低相关,心电图异常妇女存在自主神经功能失调现象,其中自主神经总体功能降低、交感神经及迷走神经的活性均降低。

Objective To investigate the occurrence of abnormal electrocardiogram and its relationship with abnormal heart rate variability(HRV)in puerperal women.Methods 128 puerperal women were selected as the study subjects.Electrocardiogram(ECG)and short range heart rate variability of 5 min were detected.According to the ECG results,they were divided into observation group(abnormal ECG)and control group(normal ECG).The short-range heart rate variability detection mainly included RR interval standard deviation(SDNN),low frequency power(LF),high frequency power(HF),total power(TF),and the ratio of low frequency power to high frequency power(LF/HF).Results Among 128 women during puerperal period,39 cases had abnormal electrocardiogram(abnormal rate of 30.5%),including 15 cases of sinus arrhythmia(including sinus tachycardia,sinus bradycardia,sinus arrhythmia,sinus node wandering rhythm,etc.),11 cases of sT-T changes,1 case of atrial premature beat,1 case of ventricular premature beat,3 cases of short P-R interval.There were I case of ventricular preexcitation,1 case of right bundle branch block,1 case of chest lead low voltage,1 case of QRS electrical alternations,and 4 cases with more than two abnormalities.There were 39 abnormal ECG patients in the observation group and 89 normal ECG patients in the control group.There were 1l abnormal HRV cases in the observation group,the abnormal rate was 28.2%.The incidence of decreased SDNN,LE,HF and TF in the observation group was significantly higher than that in the control group,and the difference was statistically significant(P<0.05).Conclusion The incidence of abnormal electrocardiogram is high in puerperal women,and the occurrence of abnormal electrocardiogram is related to the decrease of HRv.Women with abnormal electrocardiogram have the phenomenon of autonomic nervous dysfunction,in which the overall function of autonomic nerve is decreased,and the activity of sympathetic nerve and vagus nerve are decreased.