慢性充血性心力衰竭患者心率变异性与病情的相关性分析  

Relationship Between Heart Rate Variability and the Clinical Conditions of Patients With Congestive Heart Failure

作　　者：胡桃红 宋有城[1,2] 万立礼[1,2] 朱俊 王莉[1,2] 李晶[1,2] 尹彦玲 路黎明[1,2] 金律 

机构地区：[1]中国医学科学院中国协和医科大学心血管病研究所 [2]阜外心血管病医院内科

出　　处：《中国循环杂志》1996年第7期415-418,共4页Chinese Circulation Journal

摘　　要：目的：为探讨心力衰竭（心衰）患者心率变异性与病情的关系。方法：本文采用时域及频域２种分析方法，对９２例心衰患者和５１例对照组健康人进行了心率变异性对比分析，并对部分患者（ｎ＝１０）及对照组健康人（ｎ＝２０）进行血浆儿茶酚胺（去甲肾上腺素、肾上腺素）浓度测定及心率变异性随访。结果：心衰患者的心率变异性显著低于对照组健康人；并且与病情及心功能明显相关（Ｐ＜０．０５～０．００１）；心衰患者中近期死亡者心率变异性进一步降低（Ｐ＜０．０５～０．００１）；心衰患者血浆去甲肾上腺素及肾上腺素浓度明显高于健康组（Ｐ＜０．０２～０．０１）。结论：心衰患者心率变异性降低提示，心衰患者心率变异性的数量变化，反应患者病情变化。Objective:To study the relation between heart rate variability (HRV) and the clinical conditions of patients with congestive heart failure (CHF). Methods:HRV was assessed in 92 patients with CHF and 51 normal subjects as controls. HRV was analysed with a Holter analysis system, both in the time domain and frequency domain. Plasma catecholamine (NE and E) concentrations were measured in CHF ( n =10) and controls ( n =20) and HRV was follow up in those patients. Results:HRV of the CHF group was significantly lower than that in the controls and definitely related to NYHAFC ( p <0 05￣0 001). HRV of the critical CHF cases decreased further ( p <0 05￣0 001). The concentrations of NE and E were higher in the CHF group than the control group ( p <0 02￣0 01). Conclusion:The changes of HRV in patients with CHF are related to the severity of the clinical conditions. Higher concentrations of NE and E indirectly reflect that impairment of the cardiac autonomic nervous activity is the result of sustained activation of the endogenous neurohormonal system.

关 键 词：心力衰竭 充血性心力衰竭 心率变异性 

分 类 号：R541.602[医药卫生—心血管疾病]