老年卧床不起患者心率变异性特点的研究

A study of the characteristics of the HRV in the elderly bedridden patients

目的 了解老年卧床不起患者的心率变异性 (HRV)特点。 方法 选择≥ 6 0岁的住院患者 91例 ,根据功能独立试验检查 (FIM )分为功能独立组 (32例 )、部分依赖组 (31例 )和完全依赖组 (2 8例 ) ,检测动态心电图 ,分析正常RR间期标准差 (SDNN)、总功率谱 (TP)、均值的标准差(SDANN)、低频段 (LF)、均方根 (MSSD)、爱丁堡指数 (PNN5 0 )、高频段 (HF)及LF与HF的比率(LF/HF)等 8项HRV指标 ,比较组间差异。 结果 完全依赖组、部分依赖组SDNN、TP、SDANN、LF、MSSD、PNN5 0和HF较功能独立组降低 (P <0 .0 5 ) ;完全依赖组SDNN、TP和SDANN较部分依赖组降低 (P <0 .0 5 ) ;LF/HF在 3组之间差别无显著性 (P >0 .0 5 ) ;SDNN与FIM呈正相关 (r =0 .85 3 ,P <0 .0 5 )。卧床不起的病因及伴发疾病的数目对心率变异性无明显影响。 结论 老年卧床不起患者的HRV降低 ,与运动量减少有关。

Objective To investigate the characteristics of the heart rate variability(HRV) in the elderly bedridden patients. Methods 91 hospitalized patients (age≥60 years ) were divided into three groups according to the function independent measure: independent group (32 cases), partial dependent group (31 cases), dependent group(28 cases). Eight items of HRV were measured, including 24 hour standard deviation of successive normal-to-normal R-R interval(SDNN), total power (TP),standard deviation of all means of 5-minutes R-R interval all over 24 hour(SDANN), low frequency (LF), root mean squared successive difference(MSSD),Edingburgh Index(PNN50), high frequency(HF)and ratio of LF to HF(LF/HF). Results Seven items of HRV of the dependent group and partial dependent group were significantly lower than those of independent group (P<0.05). They were SDNN, TP,SDANN,LF, MSSD, PNN50 andHF. Three items of HRV of the dependent group were significantly lower than those of partial dependent group (P<0.05). They were SDNN, TP andSDANN.LF/HF was not significantly different among the three groups(P>0.05). SDNN and FIM were positively correlated (r =0.853, P=0.017). Other factors such as pathogen and the number of concomitant diseases did not affect on HRV in the elderly bedridden patients. Conclusions The HRV in the elderly bedridden patientsdecreased , the changes relatedthe decrease of the activity.