不同分期恶性肿瘤患者的心率变异性分析  

Analysis of heart rate variability in the patients with malignant tumor of different phases

作　　者：陈晨[1] 刘海媛[1] 

机构地区：[1]复旦大学上海医学院肿瘤学系-肿瘤医院心电图室,上海200032

出　　处：《复旦学报（医学版）》2009年第4期413-416,共4页Fudan University Journal of Medical Sciences

摘　　要：目的探讨心率变异性在恶性肿瘤患者诊疗中的临床意义。方法回顾性分析187例住院患者动态心率变异性检查资料,分为治疗前组90例,化疗组45例和52例非恶性肿瘤组(对照组),对不同组别和组内不同肿瘤分期患者的每5分钟正常心动周期标准差的平均数(ASDNN5)、每5分钟正常心动周期的标准差(SDANN5)、24h全部正常心动周期的标准差(SDNN)及正常相邻心动周期差值的均方的平均根(RMSSD)四项心率变异性指标进行组间和组内比较。结果肿瘤治疗前组不同分期患者的心率变异有差异,两两比较显示治疗前组Ⅲ期及Ⅳ期患者ASDNN5、SDANN5、SDNN均低于同组Ⅰ期患者及对照组(P均<0.05);治疗前组Ⅲ期仅SDNN低于同组Ⅱ期患者(P<0.05);化疗组Ⅳ期患者SDANN5,SDNN低于治疗前组Ⅳ期患者(P<0.05)。结论恶性肿瘤患者分期越晚,心率变异性降低越明显。化疗会影响Ⅳ期肿瘤患者的自主神经功能,降低心率变异性。Objective To evaluate the clinical practical value of the heart rate viability test in the patients with malignant tumor during their therapies. Methods Totally 187 cases were analyzed and were divided into three different groups, which included 90 malignant tumor patients before therapy, 45 patients with chemotherapy and 52 non-malignant tumor cases （control group）. We compared four HRV indexes（ASDNNS,SDANN5, SDNN and RMSSD） of the patients between the different groups as well as inside each group. Results There were statistical significances in the indexes of ASDNN5, SDANN5 and SDNN of patients at different stages before therapy, the three indexes of the stage Ⅲ group were lower than those of the stage Ⅰ group and the control group as well. The three indexes of the stage Ⅳ group compared with the stage Ⅰ group or the control group （P〈0. 05） were lower either. There was also statistical significances in SDNN between the stage Ⅲ and the stage Ⅱ of the before-therapy group （P 〈 0. 05）. The indexes of SDANN5 and SDNN of the stage Ⅳ in the chemotherapy group were lower than those of the same stage in the before-therapy group（P〈0.05）. Conclusions The later the stage of malignant tumor patients is, the more the index of HRV declines. Chemotherapy may affect autonomic nerve function of stage Ⅳ patients with malignant tumor and decrease their HRV.

关 键 词：恶性肿瘤 心率变异性 自主神经 

分 类 号：R730.5[医药卫生—肿瘤] R541.7[医药卫生—临床医学]