老年患者心肌缺血和左心室肥大时的心率变异性分析  

An analysis of heart rate variability in elderly patients with myocardial ischemia and left ventricular hypertrophy

作　　者：罗昭林[1] 祝善俊[1] 文芳[1] 钟杭美[1] 

机构地区：[1]第三军医大学新桥医院心内科

出　　处：《中华老年医学杂志》1998年第5期273-275,共3页Chinese Journal of Geriatrics

摘　　要：目的观察老年患者心肌缺血（ＭＩ）和左心室肥大（ＬＶＨ）时心脏自主神经张力的变化。方法对７３例老年冠心病、高血压性心脏病和原发性高血压患者与３０例健康老年人的心率变异性进行分析。结果患者组与对照组除低频（ＬＦ）外，其余参数差异均有显著性（Ｐ＜０．０５）；而不同疾病组间比较，差异均无显著性（Ｐ＞０．０５）；患者组伴有ＭＩ和ＬＶＨ与无ＭＩ和ＬＶＨ患者比较，Ｒ－Ｒ间期均方根（ｒＭＳＳＤ）、Ｒ－Ｒ间期差值＞５０ｍｓ（ＰＮＮ５０）、高频（ＨＦ）和ＬＦ／ＨＦ比值等参数差异有显著性（Ｐ＜０．０５）；无ＭＩ和ＬＶＨ患者与对照组比较，除ＨＦ（Ｐ＜０．０５）外，其余参数差异均无显著性（Ｐ＞０．０５）。结论迷走神经活性减低、交感神经活性增强是导致老年患者心率变异性减低的主要原因。Objective To observe the changes of the cardiac autonomic nervous tension in elderly patients with myocardial ischemia (MI) and left ventricular hypertrophy (LVH). Methods The heart rate variability (HRV) in 73 elderly patients with coronary heart disease (CHD),hypertensive heart disease (HHD) and essential hypertension (EH) and 30 healthy elderly subjects were investigated. Results Except the low frequency (LF) there were significant difference between HRV in the patients with CHD,HHD,EH and healthy elderly subjects ( P <0 05), but no significant difference between HRV in the patients with CHD, HHD and EH ( P >0 05). Except the high frequency (HF) there were no significant difference between HRV of the patients without MI and LVH in the patients with CHD, HHD,EH and healthy elderly subjects ( P >0 05). The root mean squared successive difference (rMSSD),percentage of adjacent normal normal interval differing by more than 50ms in the entire recording (PNN 50 ), HF and LF/HF ratio were significanty different between the patients with MI, LVH and without MI and LVH ( P <0 05). Conclusions The vagal hypoactivity and sympathetic hyperactivity were major causes of reduction of HRV, MI and LVH were important factors to cause in balance of the cardiac autonomic nervous tension in the elderly patients.

关 键 词：心肌缺血 左心室肥大 心率变异 老年人 

分 类 号：R542.202[医药卫生—心血管疾病] R541.702[医药卫生—内科学]