CAJ | 학술논문

【目的】探讨围产期心肌病（PPCM）患者和妊娠高血压疾病（PIH）患者心率变异性（HRV）时域指标变化和机制。【方法】收集PPCM患者30例（PPCM组），PIH患者30例（PIH组），正常体检者30例（对照组），比较三组 HRV时域和超声心动图指标。【结果】PPCM组和PIH组的窦性心搏间期NN标准差（SDNN）、全程记录中每5 min NN间期平均值的标准差（SDANN）、全程相邻NN间期差值的均方根（RMSSD）、相邻RR间期差值（PNN50）值均显著低于对照组，且PPCM组显著低于PIH组，其差异有显著性（P＜0．05）。三组室壁厚度比较无显著性差异（P＞0．05），PPCM组心室前后径、运动幅度和左室射血分数与PIH组、对照组比较均有显著性差异（P＜0．05）；但PIH组与对照组比较均无显著性差异（P＞0．05）。【结论】PPCM患者妊娠后期心脏组织结构和功能发生改变，因心脏重构致自主神经功能损害， HRV时域指标下降；PIH患者交感神经和副交感神经平衡紊乱，心率变异性时域指标下降。
【목적】탐토위산기심기병（PPCM）환자화임신고혈압질병（PIH）환자심솔변이성（HRV）시역지표변화화궤제。【방법】수집PPCM환자30례（PPCM조），PIH환자30례（PIH조），정상체검자30례（대조조），비교삼조 HRV시역화초성심동도지표。【결과】PPCM조화PIH조적두성심박간기NN표준차（SDNN）、전정기록중매5 min NN간기평균치적표준차（SDANN）、전정상린NN간기차치적균방근（RMSSD）、상린RR간기차치（PNN50）치균현저저우대조조，차PPCM조현저저우PIH조，기차이유현저성（P＜0．05）。삼조실벽후도비교무현저성차이（P＞0．05），PPCM조심실전후경、운동폭도화좌실사혈분수여PIH조、대조조비교균유현저성차이（P＜0．05）；단PIH조여대조조비교균무현저성차이（P＞0．05）。【결론】PPCM환자임신후기심장조직결구화공능발생개변，인심장중구치자주신경공능손해， HRV시역지표하강；PIH환자교감신경화부교감신경평형문란，심솔변이성시역지표하강。
[Objective]To explore the change of time domain index of heart rate variability(HRV)in patients with peripartum cardiomyopathy(PPCM)and pregnancy induced hypertension(PIH)and its mechanism.[Meth-ods]Totally 30 patients with PPCM(PPCM group),30 patients with PIH(PIH group)and 30 normal healthy peo-ple(control group)were collected.The indexes of time domain of HRV and echocardiography among 3 groups were compared.[Results]SDNN,SDANN,RMSSD and PNN50 in PPCM group and PIH group were markedly lower than those in control group,and those in PPCM group were markedly lower than those in PIH group,and there was significant difference(P <0.05).There was no significant difference in ventricular wall thickness a-mong 3 groups(P >0.05).There were significant differences in ventricular antero-posterior diameter,motion amplitude and EF between PPCM group and PIH group or control group(P<0.05),but there was no significant difference between PIH group and control group(P >0.05).[Conclusion]PPCM patients at third trimester of pregnancy have the change of cardiac structure and function due to autonomic nerve function damage induced by cardiac remodeling and the decreasing of time domain index of HRV.Patients with PIH have the disorder of the balance between sympathetic and parasympathetic nerve and the decreasing of time domain index of HRV.