心血管病人的心率变异性

Variability Cardiac Rhythm of Patients with Cardialascular Diseases

目的研究植物神经系统对心血管功能的影响和作用.方法采用频谱分析的方法进行临床观察.结果给缺血性心脏病病人使用东莨菪硷贴剂24 h后,所有心率变异性参数均显著增加,缺血发作的频率及持续时间均减少.在急性心肌梗死时,频谱中所有的心率变异性指数(LF,HF,VLF和ULF4个区域)均呈典型性降低,其中标准差s<20ms时,致命性室性心律失常发生率显著升高,频谱图上不同的特征改变对心衰的判断预后亦有意义.心率变异性参数分析反映了心血管病人植物神经系统功能状态,副交感神经占优势时,则疾病趋于改善,而交感神经活性增强时则疾病预后不良.结论可将心率变异性的频谱分析法用于临床诊断及疾病的风险评价.

Objective To evaluate the function and effect of vegetative nervous system on cardiolvascular system.Methods The frequency spetrum analysis was employed in clinical observation.Results 24 hours after scopolamine emplastrum was administered in the patients with ischemic heart diseases, all the frequency spectrum parameters rose significantly, and both the frequency and lasting time of the stroke of ischemia were reduced substantially. In AMI, all the VCR frequency spectrum indexes (of these four regions of LF, HF, VLF and ULF)showed a typical decreasing, and when SD was less than 20?ms, the incidence of fatal ventricular arrhythmias rose prominently. The various characteristic changes of frequency spectrum were relevant to determining prognosis, the analysis of VCR parameters reflected the function state of vagosympathetic system of patients with cardiovascular diseases, when activities of parasympathetic nervous system were predominant, the patiens tended to recover, when activities of sympathetic nervous system were enhanced, it meaned a negtive prognosis.Conclusion The frequency spectrum analysis of VCR could be adopted in clinical diagnosis and risk evaluation of dieases.