非持续性室性心动过速患者的心率变异性特点  

Changes of heart rate variability in relation to the nonsustained ventricular tachycardia

作　　者：曲哲[1] 陈葵[1] 黄从新[1] 邓汉华[1] 胡曙萍[1] 葛建[1] 左进[1] 

机构地区：[1]武汉大学人民医院心内科,430060

出　　处：《中华心律失常学杂志》2005年第5期348-350,共3页Chinese Journal of Cardiac Arrhythmias

摘　　要：目的目前有研究发现,室性心动过速(VT)的发作常常伴有低频成分的损害,并且有动态性改变。本文研究非持续性室性心动过速(NSVT)患者心率变异性(HRV)的改变,以期揭示自主神经系统状态与NSVT的关系。方法选择记录有NSVT的动态心电图96份,按有无心脏病分为:无器质性心脏病组(A组)56例,有器质性心脏病组(B组)40例,另选30例正常人作对照组(C组)。分析各组24h HRV以及NSVT发作前2h和15min HRV。结果NSVT患者较正常人的HRV时域、频域均降低。B组24h TP、LFP、LFP/HFP均较A组降低,其LFP的动态改变为在NSVT发作前2h下降,而在15min前明显升高;而A组NSVT发作前2h稍升高,到15min前明显下降。结论NSVT患者的HRV呈总体降低趋势,但在NSVT发作前低频部分的动态改变会有所不同。有器质性心脏病的NSVT患者其心率变异低频成分LFP较低,而在VT发作前会增高,与无器质性心脏病不同。在不同HRV背景下LFP的反应不同可能是器质性心脏病自主神经功能受损的一种表现。Objective The aim of this study is to detect the relationship between heart rate variability （HRV） and nonsustained ventricular tachycardia（NSVT）. Method Hoher electrocardiograph from 96 patients with NSVT recorded were analyzed. Patients were divided into those without heart diseases（ group A ,n =56）and those with heart diseases（group B ,n = 40 ）. Thirty normal people were processed Holter as control group. The 24 h HRV and the frequency domain of 2 h and 15 min before the onset of NSVT were analyzed. Results Patients with NSVT had decreased HRV compared with normal people. Time domain of A and B group had not difference,but the TP, LFP and LFP/HFP of the whole patients decreased significantly than normal control group. The 24 h TP, LFP, LFP/HFP in group B is lower than group A. LFP decreased 2 h before onset of NSVT and then increased 15 min before in group B,but it increased 2 h before onset of NSVT and decreased 15 min before NSVT in group A. Conclusion HRV decreases in NSVT patients, but low frequency before onset of NSVT has different modulation in group A and group B. The patients with heart diseases have lower low frequency and it increases before onset of NSVT compared with patients without. Different behavior of LFP to different HRV baseline may be reflect parasympathetic system damage.

关 键 词：非持续性室性心动过速 心率变异性 非持续性室性心动过速 心动过速患者 心率变异性 无器质性心脏病 自主神经系统 NSVT 低频成分 神经功能受损 动态改变 

分 类 号：R541.7[医药卫生—心血管疾病]