充血性心力衰竭患者心率变异性与心功能及心室重塑的关系  

Changes of Heart Rate Variability and Its Relativity with Cardiac Founction and Ventricular Remoulding in Patients with Congestive Heart Failure

作　　者：杨立森[1] 潘静玲[1] 石学宁[1] 方永鹏[1] 林媛豪[2] 陈树兰[1] 

机构地区：[1]宁夏医学院附属医院综合病房,银川750004 [2]宁夏医学院附属医院心内科,银川750004

出　　处：《宁夏医学院学报》2004年第5期333-334,340,共3页Journal of Ningxia Medical College

摘　　要：目的　检测充血性心力衰竭 (CHF)患者心率变异性 (HRV)改变 ,探讨其与心室重塑及心功能的关系。方法　采用Holter检测系统检测了 84例CHF患者HRV时域指标 2 4h平均R -R间期标准差 (SDNN)、2 4h内每 5min一段的平均正常R -R间期值的标准差 (SDANN)、2 4h内每 5min一段的正常R -R间期标准差的平均数 (SDNNI)、连续正常R -R间期差值的均方根 (RMSSD)和连续 2 4hR -R间期标准差≥ 5 0ms的百分数连续 2 4hR -R间期标准差≥ 5 0ms的百分数 (PNN5 0 )及超声心动图指标左心室舒张末期内径 (LVd)、收缩末期内径 (LVs)、右心室内径 (RV)、左心室后壁舒张末期厚度 (LVPW )、心室间隔舒张末期厚度 (IVS)、左心室射血分数 (LVEF)、左心室舒张早期和舒张晚期充盈速度比值 (E/A)及左心室重量指数 (LWI) ,并以 30例健康体检者作为对照。结果　与对照组比较 ,HRV各指标均下降 ,两组间有统计学意义 ;随心功能的下降 ,HRV各指标均有下降趋势 ,但SDNN、SDANN在各级间无统计学意义 ,SDNNI、RMSSD、PNN5 0在心功能I级与III、IV级间 ,RMSSD、PNN5 0在心功能III级与IV级间有统计学意义 ;多因素相关分析显示 ,LVEF、LVd与RMSSD和PNN5 0相关 ,而LVd、LWI与SDNNI相关。结论　CHF患者HRV下降 。Objectives To explore the changes of heart rate variability (HRV)and its relativity with echocardiographic parameters in patients with congestive heart failure. Methods HRV parameters including SDNN,SDANN,SDNNI,RMSSD ,PNN50 and echocardiographic parameters including LVd、LVs、RV、LVPW、IVS、LVEF、E/A、LWI were measured in 84 patients with congestive heart failure and 30 healthy controls. Results HRV parameters were significantly lower than that of controls. There was a tendency that HRV parameters ,especially RMSSD and PNN50,decreased as the heart function deteriorated. Multivariable analysis (stepwise regression) showed that LVEF and LVd were independently associated with RMSSD and PNN50, while LVd and LWI were associated with SDNNI. Conclusions The disequilibrium of autonomic nerve system and the decrease of HRV exist in patients with congestive heart failure and relate to ventricular remoulding and heart function.

关 键 词：充血性心力衰竭 心率变异性 心功能 

分 类 号：R541.61[医药卫生—心血管疾病]