心衰患者窦性心率震荡检测及多因素影响分析  

Heart rate turbulence in patients with chronic heart failure and relationship to clinical factors

作　　者：赵进军[1] 赵继义[1] 毕亚艳[1] 高冠宇[1] 章洪英[1] 黄永麟[1] 

机构地区：[1]哈尔滨医科大学第一临床医学院心内科,150001

出　　处：《中国实用内科杂志》2005年第1期46-47,73,共3页Chinese Journal of Practical Internal Medicine

摘　　要：目的　观察心力衰竭患者窦性心率震荡 (HRT)现象的特征并探讨其临床意义。方法　 2 0 0 4 - 0 1～ 0 4哈尔滨医科大学第一临床医学院门诊 30例心衰患者及 30名健康对照者均接受 2 4hHolter检查 ,分别计算HRT的初始值 (TO)、HRT的斜率 (TS) ,并进行TO、TS与年龄、左室射血分数 (LVEF)、左室舒张末期内径 (LVED)、室早数目、室早前心率、联律间期、代偿间期的相关分析及不同起源室早TO、TS的组间比较。结果　心衰者与健康者HRT间存在明显差别 :心衰者TO明显高于对照者 (0 5 7± 4 71%与 - 1 5 6± 2 6 0 % ,P <0 0 2 5 ) ;心衰者TS明显低于对照者 (3 17± 2 0 3%与 9 6 4± 6 4 7,P <0 0 0 1)。TO、TS与年龄、LVEF、LVED、室早数目相关 ,与室早前心率、联律间期、代偿间期不相关 ,起源不同室早的TO、TS间无明显差异。结论　慢性心衰患者中窦性心率震荡现象明显减弱 ,由于TO、TS与LVEF、LVED相关 ,可凭借TO、TS对心衰患者进行危险分层 ,但它对预后的预测价值有待于大样本长期随访来证实。Objective To investigate the change of heart rate turbulence in patients with chronic heart failure and relationship to age、LVEF、LVED、heart rate before ventricular premature complex (VPC)、coupling interval、compensatory interval、the number and origin of VPC.Methods HRT was measured in 30 CHF patients and 30 healthy controls.HRT onset and slope were measured by the original definitions using Holter records and compared with the clinical factors.Results The HRT TS was significantly lower in patients wtih heart failure than in control (3.17±2.03vs9.64±6.47,P<0.001).The HRT TO in patients with CHF was significantly higher than that in control (0.57±4.71%vs-1.56±2.60%,P<0.025).HRT in CHF was influenced by age、LVEF、LVED、 the number of VPC and didn't correlate with heart rate before VPC、coupling interval、compensatory interval、the origin of VPC.Conclusion Heart rate turbulence is significantly blunted in CHF patients and influenced by several clinical factors .Its prognostic value should be evaluated by long follow-up.

关 键 词：室早 心衰 心率 患者 TS 窦性 HRT 目的观 结论 现象 

分 类 号：R541.7[医药卫生—心血管疾病] R746[医药卫生—内科学]