冠状动脉病变与心率变异关系的评价

Relationship between coronary lesions and heart rate variability

目的 通过冠状动脉造影和心率变异的测定评价冠状动脉病变与心率变异的关系,预测冠心病的预后。方法 对31例冠心病患者根据冠状动脉病变程度和部位进行分组,并与27例健康人比较。结果 冠状动脉病变组所有指标(时域指标SDNN、SDANN、RMSSD、SDNN Index、PNN_(50)和频域指标TP、VLF、VF、HF)均明显低于健康组(P<0.05～0.01)。冠状动脉病变组时域指标降低尤为显著。冠状动脉双支、三支病变和严重狭窄时域指标(SDNN、PNN_(50)％)和频域指标(LF、HF)均明显低于病变较轻者(P<0.05～0.01)。冠状动脉不同病变部位之间心率变异指标无明显差异。结论 心率变异指标可以反映冠心病的严重程度和预后。

Objective To evaluate the influence of angiographic severity of coronary artery disease on cardiac autonomic control by means of HRV analysis. Methods 31 patients with CHD and 27 healthy controls were involved in the study. There were 14 patients with MI and 17 patients with unstable angina pectoris. All the subjects were performed 24-hour ambulatory electrocardiogram and the parameters of HRV were obtained from the computer, including time domain(SDNN, SDANN, RMSSD, SDNN index, PNN_(50)) and frequency domain(TP, VLF, VF,HF). All the patients underwent angiographic examination by the Jukdins technique. Results Compared with the control group, all the values of HRV (including time domain and frequency domain)were markedly and significantly reduced in CHD patients (P<0.05～0.01), specially in double-vessel,triple-vessel disease groups and 90%～100% narrowing disease group(P<0.05～0.01). Conclusion The indices of HRV significantly reflected the impairment of sympathetic and parasympathetic function in the patients with CHD.