冠心病心肌缺血患者的心率变异分析  

ANALYSIS OF HEART RATE VARIABILITY DURING MYOCARDIAL ISCHEMIA IN CORONARY ARTERY DISEASE

作　　者：卜培莉[1] 张朝林 黎莉[1] 李传义[1] 张运[1] 高海青[1] 潘秀荣[1] 徐庆来[1] 

机构地区：[1]山东医科大学附属医院心内科 干部保健科

出　　处：《山东医科大学学报》1996年第4期302-305,共4页Acta Academiae Medicinae Shandong

摘　　要：为探讨冠心病心肌缺血患者自主神经活动及心率变异（ＨＲＶ）变化的临床意义，分析了２２名正常人和３５例冠心病患者１０８阵心肌缺血前及发作时的ＨＲＶ。结果显示，冠心病患者心率变异降低，主要是副交感神经活性降低（ＨＦ３１６．５８±９３．６０比２０４．３４±６４．６１，Ｐ＜０．０５），阵发性心肌缺血前５ｍｉｎ内及发作时副交感神经活性降低更明显（ＨＦ２１３．５４±５８．９１比１３６．７５±１７．５２，Ｐ＜０．０５），并可能有继发性交感神经活性增强，提示植物神经功能改变导致冠状动脉张力变化而致心肌缺血。Function of sympathetic and parasympathtic nerves can be assessed noninvasive with analysis of heart rate variability(HRV). To study the clinical signification of autonomic nerve activity and HRV change in patients with myocardial ischemia due to coronary artery disease (CAD),HRV were analysed in 22 normal subjects and 35 patients with myocardial ichemia in CAD. The result showed that parasympathetic activity decreased in patients with CAD(SD74. 59±20. 01 vs 45. 73± 13. 28,HF 316. 58±193. 60 vs 204. 34 ±164. 51). In the five minutes before and during the attack of myocardial ischemia which was indicated by 24-hour ambulatory ST-segment depression, parasympathetic activity decreased more distinctly(HF213. 54±158. 91 vs 136. 75±117. 52, PNN50 5. 52±5. 45 vs 2. 63±1. 56ms ,SDANN 70. 17 ± 36. 66 vs 65. 54 ± 24.63 % )and sympathetic activity might increase secondarily. The result suggested that the tone of autonomin nerve affect the coronary artery tension and induce myocardial ischemia.

关 键 词：心率变异 冠心病 心肌缺血 

分 类 号：R541.402[医药卫生—心血管疾病] R331.36[医药卫生—内科学]