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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:

20卷

期数:

2014年05期

页码:

363-365

栏目:

临床医学

出版日期:

2014-09-20

文章信息/Info

Title:

Analysis on heart rate variability in heart failure patients with coronary heart disease

文章编号:

1006-8147(2014)05-0363-03

作者:

彭云玲¹; 2; 齐 新²; 魏丽萍²; 周 钧³

(1.天津医科大研究生院,天津 300070;2.天津市人民医院心内三科,天津300121;3.天津中医药大学研究生院,天津 300193)

Author(s):

PENG Yun-ling^{1 2} ; QI Xin² ; WEI Li-ping² ; ZHOU Jun³

(1.Graduate School , Tianjin Medical University,Tianjin 300070,China;2. Department of Cardiology ,Tianjin Union Medicine Center,Tianjin 300121,China; 3.Graduate School , Tianjin University of Traditional Chinese Medicine,Tianjin 300193,China)

关键词:

冠心病; 心力衰竭; 心功能; 心率变异性

Keywords:

coronary heart disease ; heart failure ; heart function ; heart rate variability

分类号:

R541.4

DOI:

-

文献标志码:

A

摘要:

目的 ：检测不同程度冠心病心力衰竭患者心率变异性（HRV）的变化情况，探讨心率变异性与心功能的相关性及其在心力衰竭患者病情评估中的作用。方法： 采用HOLTER检测系统检测123例冠心病心力衰竭患者HRV 中的SDNN、SDNNI、RMSSD、PNN50及三角指数，并以30例健康人群作为对照组。结果 ：与对照组比较SDNN、RMSSD、PNN50、三角指数明显减低，且差异均有统计学意义(P＜0.05)，SDNNI减低但差异无统计学意义。将心功能分级与HRV各指标进行相关性分析，提示NYHA心功能分级与HRV各指标呈负相关，随心功能降低心率变异性各指标明显降低。多元逐步回归分析SDNN和PNN50进入回归方程，Y=3.422-0.011SDNN-0.057pNN50。结论： 冠心病心力衰竭患者心率变异性降低，且随心功能的降低，心率变异性逐渐降低，心率变异性中SDNN、PNN50指标对心功能的评估有较好的临床意义。

Abstract:

 Objective:To observe heart rate variability in heart failure patients with coronary heart disease， and to explore the correlation between heart rate variability(HRV) and heart function and evaluate the value of HRV in this patients. Methods: One hundred and twenty-three patients with varied degrees of coronary heart disease (CHD)and heart failure (CHF group) and 30 healthy people (control group) were involved in this study .They were examined by 24 h Holter monitoring. The HRV in time domain and the triangle index were analyzed. Results: The time domain and triangle index of CHF group were lower than the control group at all levels, and they were statistically different(P＜0.05). The SDNNI were lower but with no statistical difference. The analysis of heart function and HRV indexes suggested that NYHA class and HRV indexes had negatively correlations, and heart function decreased with the HRV indexes. Multivariate regression analysis demonstrated regression equation with SDNN and PNN50, Y = 3.422-0.011SDNN-0.057pNN50. Conclusion： Heart rate variability is decreased with the reduced heart function in patients with CHD , SDNN and PNN50 are especially more clinically effective） in assessing cardiac function.

参考文献/References:

[1]黄峻. 慢性心力衰竭诊断和治疗2012:现状和进步[J]. 心血管病学进展, 2012,33(1):1
[2]洪必莹，何森，陈晓平. 心率变异性研究进展[J]. 华西医学, 2013,28(4):614
[3]Khurana S, Raufman J P, Pallone T L. Bile acids regulate cardiovascular function [J]. Clin Transl Sci, 2011,4():210
[4]Huang H H, Tseng C Y, Fan J S, et al. Alternations of heart rate variability at lower altitude in the predication of trekkers with acute mountain sickness at high altitude[J]. Clin J Sport Med, 2010,20(1):58
[5]吴晓霞，万涛，吴红金，等. 全基因组芯片结合通路分析筛选心力衰竭患者心肌细胞差异基因[J]. 中华心血管病杂志, 2009,37(2):120
[6]M?kikallio T H, Tapanainen J M, Tulppo M P, et al. Clinical applicability of heart rate variability analysis by methods based on nonlinear dynamics[J]. Card Electrophysiol Rev, 2002,6(3):250
[7]Galinier M, Pathak A, Fourcade J, et al. Depressed low frequency power of heart rate variability as an Independent predictor of sudden death in chronic heart failure[J]. Eur Heart J, 2000,21(6):475
[8]Freeman J V, Dewey F E, Hadley D M, et al. Autonomic nervous system interaction with the cardiovascular system during exercise[J]. Prog Cardiovasc Dis, 2006,48(5):342
[9]向凝. 氨基末端B型利钠肽前体联合血红蛋白对充血性心力衰竭患者病情的评估价值[J]. 中国全科医学, 2011,14(5):500
[10]王春梅，Wu X S, 韩智红，等. 心率对急性心肌梗死患者住院期间病死率的影响[J]. 中华心血管病杂志, 2008,36(7):594
[11]Huikuri H V, Raatikainen M, Moerch-Joergensen R, et al. Prediction of fatal or near-fatal cardiac arrhythmia events in patients with depressed left ventricular function after an acute myocardial infarction?[J]. Eur Heart J, 2009,30(6):689

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备注/Memo

备注/Memo:

基金项目 国家自然科学基金资助（81200158）

作者简介 彭云玲（1987~），女，硕士在读，研究方向：心血管专业；

通信作者：齐新，E-mail:qixinx2011@126.com。

常用功能

更新日期/Last Update: 2014-09-25