论文部分内容阅读
目的检测慢性充血性心力衰竭(CHF)患者的心率变异性(HRV),探讨其与心脏功能及心室结构的关系。方法采用24小时动态心电图检测58例CHF患者HRV指标:24h正常R-R间期标准差(SDNN)、24h内每5min平均正常R-R间期的标准差(SDANN)、24h内每5min的正常R-R间期标准差的平均值(SDNNI)、相邻正常R-R间期差值的均方根(rMSSD)、相邻正常R-R间期差值≥50ms心搏数占总R-R间期数的百分数(PNN50),并对每位患者行超声心动图检查记录左心室舒张末期内径(LVEDD)、左心室后壁舒张末期厚度(LVPWT)、心室间隔舒张末期厚度(IVST)、左心室射血分数(LVEF),并与21例心功能正常者对照。结果CHF患者HRV各时域指标均下降,与对照组相比有显著差异(P<0.05)。SDNN、SDANN、SDNNI在心功能Ⅲ、Ⅳ级与心功能Ⅱ级比较;SDNN、SDANNI在LVEF≤35%与LVEF>35%比较;SDANN在LVEDD>60mm比较,差异均有统计学意义(P<0.01或<0.05)。结论CHF患者HRV下降,并与心脏功能及心室结构有一定的相关。
Objective To detect heart rate variability (HRV) in patients with chronic congestive heart failure (CHF) and to investigate its relationship with cardiac function and ventricular structure. Methods HRV indexes of 58 CHF patients were determined by 24-hour Holter monitoring. SDNN of 24h normal RR, standard deviation of average normal RR every 5min in 24h, normal RR of every 5min in 24h Standard deviation mean (SDNNI), root mean square (rMSSD) of adjacent normal RR interval, percentage of adjacent normal RR interval ≥50ms heart rate in total RR interval (PNN50) Left ventricular end-diastolic diameter (LVEDD), left ventricular end-diastolic thickness (LVPWT), end-diastolic end-diastolic thickness (IVST) and left ventricular ejection fraction (LVEF) were recorded by echocardiography. With 21 cases of normal heart function control. Results The indexes of HRV in each time-domain of CHF patients decreased significantly compared with the control group (P <0.05). SDNN, SDANN and SDNNI were compared with those of heart function Ⅲ and Ⅳ and heart function Ⅱ; SDNN and SDANNI were compared between LVEF≤35% and LVEF> 35%; SDANN was higher than LVEDD> 60mm (P <0.01) Or <0.05). Conclusion The HRV of CHF patients is decreased, and has some correlation with cardiac function and ventricular structure.