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目的通过对慢性心功能不全患儿24 h心率变异的分析,探讨其与慢性心功能不全严重程度及预后的关系。方法选取2004年1月-2008年12月在本院门诊或住院治疗的慢性心功能不全患儿39例(心功能不全组),在排除了复杂性室性期前收缩等影响心率变异性的疾病后,按纽约心脏病学会(NYHA)心功能分级标准,Ⅰ级4例,Ⅱ级11例,Ⅲ级14例,Ⅳ级10例。健康对照组15例为本院同期体检健康儿童。比较不同心功能分级与心率变异性的关系。结果与健康对照组比较,心功能不全组全部正常窦性心搏R-R间期的标准差(SDNN)、每5 min R-R间期标准差(SDANN)、相邻R-R间期差值>50 ms的个数占R-R间期总数的百分比(PNN50)、全程相邻R-R间期差值的均方根(rMSSD)和高频功率(HF)显著降低,低频/高频(CF/HF)增高(Pa<0.01),心功能Ⅲ级、Ⅳ级与Ⅰ级、Ⅱ级组比较,SDNN、SDANN、PNN50、rMSSD和HF显著降低,LF/AF增高(Pa<0.01)。结论儿童慢性心功能不全与心率变异性有关,心功能不全程度越重,降低越明显。
Objective To investigate the relationship between 24-hour heart rate variability and chronic heart failure severity and prognosis in children with chronic heart failure. Methods From January 2004 to December 2008 in our hospital outpatient or inpatient treatment of 39 patients with chronic heart failure (cardiac insufficiency group), in ruled out the complicated ventricular contraction and other heart rate variability After the disease, according to New York Heart Association (NYHA) classification of cardiac function, grade Ⅰ in 4 cases, Ⅱ grade in 11 cases, Ⅲ grade in 14 cases, Ⅳ grade in 10 cases. The healthy control group of 15 cases of hospital-based health check-up children. The relationship between different cardiac function classification and heart rate variability was compared. Results Compared with the healthy control group, the SDNN of all normal sinus beats, SDANN of every 5 min, the number of adjacent RR intervals> 50 ms (RmsSD) and high frequency power (HF) of the whole RR interval difference decreased significantly and the low frequency / high frequency (CF / HF) increased (Pa <0.01) as a percentage of the total number of RR intervals (PNN50) (P <0.01). SDNN, SDANN, PNN50, rMSSD and HF were significantly decreased, and LF / AF increased (P <0.01). Conclusion Children with chronic heart failure and heart rate variability, heart failure, the more serious, the more obvious reduction.