心率变异性与冠心病短暂性心肌缺血的关系

THE RELATION BETWEEN HEART RATE VARIABILITY AND TRANSIENT MYOCARDIAL ISCHEMIA IN CORONARY HEART DISEASE

①目的 探讨冠心病心肌缺血发作时心脏自主神经活动的特点。②方法 对 5 0例冠心病心肌缺血病人与 4 0例正常人的心率变异性 (HRV )各指标进行检测分析。③结果 冠心病组SDNN、SDANN、RMSSD、PNN5 0、HF显著低于对照组 (t=3.175～ 4 .5 12 ,P <0 .0 1) ,LF/HF显著高于对照组 (t =3.2 6 8,P <0 .0 1)。心肌缺血发作时HF显著低于ST段压低后 1h(t =3.375 ,P <0 .0 1) ,LF、LF/HF显著高于ST段压低后 1h(t =3.2 10、3.92 5 ,P <0 .0 1)。④结论 冠心病病人的自主神经活动受损 ,迷走神经张力减弱 ,而交感神经张力相对亢进 ,发生恶性心律失常的危险性增加。

Objective\ To observe the characteristics of activity of heart autonomic nervous system during the episode of myocardial isch emia in coronary heart disease(CHD). \ Methods\ Parameters of heart rate variability(HRV) were detected a nd analyzed in 50 CHD patients and 40 healthy persons.\ Results\ Compared with control group , SDNN,SDANN,RMSSD,PNN50 a nd HF in CHD group showed significantly decreased ( t=3.175-4.512,P <0.01) , LF/HF showed markedly increased ( t= 3.268 , P <0.01). During the attac k of myocardial ischemia , HF in CHD group was obviously lower than that of one hour after the ST segment was depressed ( t=3.375,P <0.01) and LF and LF/H F were higher ( t=3.210,3.925; P <0.01).\ Conclusion The activity of autonomic nervous system in CHD patients is damaged , the tone of pneumogastric nerve weakened and of sympat hetic nerve relatively excited, thus the risk of malignant arrhythmia in creases. Transient myocardial ischemia in CHD patients is closely related to H RV.