持续性心房颤动心室律的昼夜节律变化  

Circadian measures of ventricular response to atrial fibrillation

作　　者：谢元芳[1] 王子时[2] 王秋明[2] 曹济民[1] 王茜[1] 马天龙[1] 郭亚峰[1] 杨啸林[1] 张正国[1] 

机构地区：[1]中国协和医科大学基础医学院中国医学科学院基础医学研究所,北京100005 [2]中国北京协和医院,北京100730

出　　处：《国际生物医学工程杂志》2006年第5期257-259,266,共4页International Journal of Biomedical Engineering

基　　金：CMB基金资助项目(03-787);国家自然科学基金资助项目(30370394)

摘　　要：目的从持续性心房颤动心电图的心室律变化动力学的角度,探讨心房颤动的心电信号中心室律昼夜节律的变化规律,为心房颤动的治疗提供有意义的思路。方法用时域、近似熵和分形分析对31份24h的心房颤动Holter心电图和18份正常人的24h Holter心电图的心室律及其昼夜节律进行了分析。结果心房颤动患者的心室率的SDA、RMSSD和近似熵的24h均值显著地高于正常组,但是都表现出冥想的类似的昼夜节律。心房颤动的心室率的分形指数显著低于正常人,而表现出近似白噪的动力学特性,并且失去了昼夜节律。结论心房颤动的心室律在时域和近似熵上具有和正常人类似的昼夜节律,而其分形特性则不具有正常人所具有的昼夜节律。Objective Based on the dynamical analysis of ventricular interval, this study aimed to investigate the circadian variation of VR! in atrial fibrillation（AF） and thus provide potential clues of clinical therapy for AF. Methods The circadian pattern of 24 h ventricular response interval was measured from Hoher ECGs of eighteen persistent AF patients and thirty-one of the normal subjects. Analysis was carried out with time domain, approximate entropy and fractal analysis. Results Although the mean value of SDA, RMSSD and approximate entropy of ventricular response interval were significantly higher in the AF than in the normal, all of them showed similar circadian rhythm in both groups. The fractal analysis exponents were significantly lower in the AF than in the normal. Both short term and long term exponents failed to present the circadian rhythm in AF. Conclusion Obvious circadian rhythm presented in the time domain and entropy analysis in the ventricular response interval of AF which was similar to the normal. However, circadian variation presented in the normal absented in the fractal dynamics of AF.

关 键 词：持续性心房颤动 分形分析 近似熵 昼夜节律 

分 类 号：R541.75[医药卫生—心血管疾病]