慢性心力衰竭病人的心率变异性及左旋甲状腺素钠的干预作用  

Relation between Heart Rate Variability and Chronic Heart Failure and Effect of Euthyeox 50 on Heart Rate Variability

作　　者：杨德辉[1] 许晓琼[1] 朱新林[1] 刘春慧[1] 

机构地区：[1]中国人民解放军第一六三医院

出　　处：《中西医结合心脑血管病杂志》2008年第6期643-645,共3页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

摘　　要：目的探讨慢性心力衰竭(CHF)病人心率变异性(HRV)的变化。研究HRV各指标与CHF类型、原发病、心功能关系及左旋甲状腺素钠(优甲乐)对CHF病人HRV的影响。方法选择CHF病人114例,分为左心衰竭组、右心衰竭组、全心衰竭组,并以38名健康对照者进行比较。记录每位个病人治疗前的HRV、慢性心力衰竭类型、原发病、心功能。对CHF 114例中低三碘甲状腺原氨酸(T3)的60例CHF病人随机分为两组,每组30例。对照组给予常规抗心力衰竭治疗,治疗组在常规抗心力衰竭治疗基础上加服优甲乐50μg/d,口服。治疗前和治疗3个月后分别测定两组病人的HRV指标并进行比较;出院后随访半年,记录再住院率、病死率。结果CHF病人24 h总的NN间期标准差(SDNN)、24 h总的NN间期平均值的标准差(SDANN)较正常对照组降低,且随着CHF心功能程度的加重而逐渐降低;与左心衰竭组、右心衰竭组比较,全心衰竭组SDNN、SDANN降低(P<0.01)。治疗3个月后,治疗组的SDNN、SDANN均较治疗前及对照组明显提高(P<0.05)。结论病人HRV部分指标变化可作为判定严重程度的参考指标。各项HRV指标变化大小可能与病人的原发病无关,但部分似与CHF类型、心功能程度有关。在常规抗心力衰竭治疗的基础上,加用优甲乐治疗CHF,可提高病人HRV,增强疗效,改善预后。Objective To probe the relationship between heart rate variability （HRV） and chronic heart failure （CHF）, and to investi- gate the effect of Euthyrox 50 on HRV. Methods One hundred and fourteen patients （pts） CHF were divided into 3 groups based on heart function： Left heart failure group, right heart failure group and left and right heart failure group. And 38 healthy subjects served as normal group. Sixty pts with low T3 in all 114 pts were divided into routine treatment group （ n = 30） and Euthyrox group （ n = 30）. The data of heart function and HRV in all pts with CHF were collected and compared pre - and post therapy. Results The HRV （SDNN, SDANN） in pts with CHF was lower than that in normal subjects （P〈0.05 or P〈0.01）. The more severe the heart failure, the more lowly the HRV （P 〈 0.01 in all）. The SDNN and SDANN in pts with whole CHF were significantly lower than that in pts only with left or right CHF （P 〈 0.05 or P 〈 0.01 ）. The SDNN and SDANN in Euthyrox group was different significantly pre- and post- treatment （P 〈 0.05 ）. Conclusion HRV could be used to judge the severity of CHF. There was no relationship probably between HRV and different heart disease.

关 键 词：心力衰竭 心率变异性 左旋甲状腺素钠 

分 类 号：R541.6[医药卫生—心血管疾病] R256.2[医药卫生—内科学]