扩张型心肌病患者窦性心律震荡现象临床研究  

Clinical study on heart the turbelence in dilated cardiomyopathy

作　　者：汪永辉[1] 周仁秀[1] 彭中[1] 

机构地区：[1]泸县人民医院,四川泸县646106

出　　处：《现代医药卫生》2009年第6期817-819,共3页Journal of Modern Medicine & Health

摘　　要：目的:探讨心电学指标-窦性心率震荡(heartrate turbulence,HRT)在扩张型心肌病(DCM)患者中的变化,以及与心率变异性时阈指标(SDNN)、左室射血分数(LVEF)、左室舒张末期内径(LVEDD)的关系及对心脏性猝死的预测价值。方法:选择DCM患者36例,正常健康对照者32例,根据24h动态心电图(Holter)记录资料,计算HRT的两个参数:震荡初始(turbulenceonset,TO)和震荡斜率(turbulenceslope,TS),比较两组之间的差别,并计算TO、TS与SDNN、LVEF、LVEDD之间的相关性。结果:DCM组TO值显著高于对照组[(3.38±5.45)%vs(-6.08±3.76)%,P<0.05];DCM组TS值显著低于对照组[(5.76±5.33)ms/RR间期vs(12.68±5.84)ms/RR间期,P<0.05]。DCM患者中TO与SDNN、LVEF、LVEDD之间明显相关。结论:DCM患者室性早搏后的HRT现象减弱,HRT可能成为评价DCM患者自主神经功能状态的一个新指标,可用来预测DCM患者心源性猝死的风险。Objective：To study the change of heart rate turbulence（HRT） in dilated cardiomyopathy（DCM） and its relationship with standard deviation of normal-to-normal R-R interals（SDNN）,left ventricular ejection fraction（LVEF） and left ventricular end-diastolic diameter （LVEDD）. Methods：36 patients with dilated cardiomyopathy and 22 control subjects were investigated. HRT onset and slope were measured by the original definitions using Holter records and analysed its relevance with SDNN,LVEF and LVEDD. Results：The value of the HRT onset was significantly higher in DCM group than that in control group[（3.38±5.45） % vs（-6.08±3.76）% ,P〈0.05];the value of the HRT slope in DCM group was significantly lower than that in control group [（5.76±5.33）ms/RR interval vs（ 12.68±5.84）ms/RR interval,P〈0.05].There was a significant correlation between TO and SDNN, LVEF, LVEDD in DCM patients. Conclusion：Heart rate turbulence is dramatically blunted in DCM patients and maybe become a new predictor of the cardiac autonomic status and risk of sudden cardiac death in DCM patients.

关 键 词：扩张型心肌病 窦性心率震荡 心源性猝死 

分 类 号：R5[医药卫生—内科学]