中国循证心血管医学杂志
中國循證心血管醫學雜誌
중국순증심혈관의학잡지
CHINESE JOURNAL OF EVIDENCE-BASES CARDIOVASCULAR MEDICINE
2014年
3期
302-305
,共4页
沈艳芳%蒋学俊%雷玉华%黄浩
瀋豔芳%蔣學俊%雷玉華%黃浩
침염방%장학준%뢰옥화%황호
心率变异性%冠心病%左室射血分数
心率變異性%冠心病%左室射血分數
심솔변이성%관심병%좌실사혈분수
Heart rate variability%Coronary heart disease%Left ventricular ejection fraction
目的:了解冠状动脉粥样硬化性心脏病(冠心病)患者心率变异性(HRV)特点。方法入选156例冠心病患者及128例正常体检人员,进行24小时动态心电图监测。冠心病组通过彩色多普勒超声显像仪测量心功能(LVEF)并分组为射血分数正常组(LVEF≥50%)和射血分数下降组(LVEF<50%),同时对冠心病组进行不同年龄段的分组,计算各组的心率变异性参数:NN间期标准差(SDNN)、NN间期平均值的标准差(SDANN)、相邻NN间期差的均方根(RMSSD)、相邻NN间期的差值超过50 ms的心搏数占NN间期总心搏数的百分比(pNN50)、5分钟总功率(TP)、低频功率(LF)、高频功率(HF),通过组间比较分析,分析比较各组间HRV参数的特点。结果与正常对照组比较,冠心病组患者SDNN(96.2±28.8 ms vs.138.1±27.7 ms)、SDANN(79.4±27.1 ms vs.130.4±28.2 ms)、RMSSD(24.3±9.8 ms vs.31.2±9.3 ms)、pNN50(8.5±3.2 ms vs.12.3±3.9 ms)及HF(233.6±95.5 ms2 vs.292.3±100.2 ms2)均明显下降,差异均有统计学意义(P均<0.05)。冠心病患者中,射血分数下降组患者SDNN、SDANN、RMSSD、pNN50、TP、HF均较射血分数正常组患者降低,差异均有统计学意义(P均<0.05),在不同年龄段冠心病组间SDNN、TP以及RMSSD、pNN50、LF、HF水平比较,差异无统计学意义(P>0.05);35~45岁组SDANN高于55~65岁组,差异有统计学意义(P<0.05)。结论冠心病患者心率变异性降低,射血分数下降会进一步加重自主神经的损害。
目的:瞭解冠狀動脈粥樣硬化性心髒病(冠心病)患者心率變異性(HRV)特點。方法入選156例冠心病患者及128例正常體檢人員,進行24小時動態心電圖鑑測。冠心病組通過綵色多普勒超聲顯像儀測量心功能(LVEF)併分組為射血分數正常組(LVEF≥50%)和射血分數下降組(LVEF<50%),同時對冠心病組進行不同年齡段的分組,計算各組的心率變異性參數:NN間期標準差(SDNN)、NN間期平均值的標準差(SDANN)、相鄰NN間期差的均方根(RMSSD)、相鄰NN間期的差值超過50 ms的心搏數佔NN間期總心搏數的百分比(pNN50)、5分鐘總功率(TP)、低頻功率(LF)、高頻功率(HF),通過組間比較分析,分析比較各組間HRV參數的特點。結果與正常對照組比較,冠心病組患者SDNN(96.2±28.8 ms vs.138.1±27.7 ms)、SDANN(79.4±27.1 ms vs.130.4±28.2 ms)、RMSSD(24.3±9.8 ms vs.31.2±9.3 ms)、pNN50(8.5±3.2 ms vs.12.3±3.9 ms)及HF(233.6±95.5 ms2 vs.292.3±100.2 ms2)均明顯下降,差異均有統計學意義(P均<0.05)。冠心病患者中,射血分數下降組患者SDNN、SDANN、RMSSD、pNN50、TP、HF均較射血分數正常組患者降低,差異均有統計學意義(P均<0.05),在不同年齡段冠心病組間SDNN、TP以及RMSSD、pNN50、LF、HF水平比較,差異無統計學意義(P>0.05);35~45歲組SDANN高于55~65歲組,差異有統計學意義(P<0.05)。結論冠心病患者心率變異性降低,射血分數下降會進一步加重自主神經的損害。
목적:료해관상동맥죽양경화성심장병(관심병)환자심솔변이성(HRV)특점。방법입선156례관심병환자급128례정상체검인원,진행24소시동태심전도감측。관심병조통과채색다보륵초성현상의측량심공능(LVEF)병분조위사혈분수정상조(LVEF≥50%)화사혈분수하강조(LVEF<50%),동시대관심병조진행불동년령단적분조,계산각조적심솔변이성삼수:NN간기표준차(SDNN)、NN간기평균치적표준차(SDANN)、상린NN간기차적균방근(RMSSD)、상린NN간기적차치초과50 ms적심박수점NN간기총심박수적백분비(pNN50)、5분종총공솔(TP)、저빈공솔(LF)、고빈공솔(HF),통과조간비교분석,분석비교각조간HRV삼수적특점。결과여정상대조조비교,관심병조환자SDNN(96.2±28.8 ms vs.138.1±27.7 ms)、SDANN(79.4±27.1 ms vs.130.4±28.2 ms)、RMSSD(24.3±9.8 ms vs.31.2±9.3 ms)、pNN50(8.5±3.2 ms vs.12.3±3.9 ms)급HF(233.6±95.5 ms2 vs.292.3±100.2 ms2)균명현하강,차이균유통계학의의(P균<0.05)。관심병환자중,사혈분수하강조환자SDNN、SDANN、RMSSD、pNN50、TP、HF균교사혈분수정상조환자강저,차이균유통계학의의(P균<0.05),재불동년령단관심병조간SDNN、TP이급RMSSD、pNN50、LF、HF수평비교,차이무통계학의의(P>0.05);35~45세조SDANN고우55~65세조,차이유통계학의의(P<0.05)。결론관심병환자심솔변이성강저,사혈분수하강회진일보가중자주신경적손해。
Objective To understand the features of heart rate variability (HRV) in the patients with coronary heart disease (CHD). Methods CHD patients (CHD group, n=156) and normal medical examiners (control group, n=128) were chosen and given 24-h ambulatory blood pressure monitoring (ABPM). CHD group was given color Doppler ultrasonic imaging apparatus for measuring left ventricular ejection fraction (LVEF) and then divided into normal LVEF group (LVEF≥50%) and lower LVEF group (LVEF<50%), and meanwhile CHD group was divided into groups according to age. The parameters of HRV were calculated including SDNN, SDANN, RMSSD, pNN50, TP, LF and HF, and the features of these parameters were compared and analyzed among all groups. Results SDNN (96.2±28.8 ms vs. 138.1±27.7 ms), SDANN (79.4±27.1 ms vs. 130.4±28.2 ms), RMSSD (24.3 ms±9.8 vs. 31.2 ±9.3 ms), pNN50 (8.5±3.2 ms vs. 12.3±3.9 ms) and HF (233.6±95.5 ms2 vs. 292.3±100.2 ms2) all decreased significantly in CHD group compared with control group (all P<0.05). SDNN, SDANN, RMSSD, pNN50, TP and HF decreased in lower LVEF group compared with normal LVEF group (all P<0.05), while the comparison in SDNN, TP, RMSSD, pNN50, LF and HF showed no statistical difference among different age groups (P>0.05). SDANN was higher in 35-45 year-old group than that in 55-65 year-old group (P<0.05). Conclusion In CHD patients, HRV decreases, and the decrease of LVEF will further exacerbate the damage of autonomic nervous function.