常规潜艇水下状态对人体24h动态心电图窦性心率和心率变异性的影响  

Influence of underwater voyage of conventional submarine on the sinus rhythm and heart rate variability in 24-hour electrocardiogram of the crew

作　　者：张帆[1] 孙强[1] 解汝庆 李俊 王明刚 张新[1] 高百春[1] 

机构地区：[1]解放军401医院特检科,山东青岛266071 [2]解放军北海舰队卫生室 [3]青岛市立医院特检科 [4]解放军401医院器械科,山东青岛266071

出　　处：《解放军医学杂志》2009年第10期1255-1256,共2页Medical Journal of Chinese People's Liberation Army

摘　　要：目的探讨常规潜艇水下状态对人体24h动态心电图窦性心率和心率变异性的影响。方法自2002年3月-2009年7月纳入124名常规潜艇水下航行状态的艇员作为水下组,另选118名陆勤战士作为陆上组(对照组),均为男性。采用12导联动态心电图检查分析系统,对常规潜艇水下状态的艇员进行连续24h动态心电图监测,记录24h平均心率、工作时平均心率及最高心率、睡眠时平均心率和最低心率,并分析水下组与陆上组心率变异性指标的差异。结果与陆上组相比,水下组睡眠时平均心率及最低心率明显加快(P<0.01),但24h平均心率,工作时最高心率及平均心率均无明显差异。24h心率变异性比较,水下组相邻R-R间期差值的均方根值(rMSSD)、正常相邻R-R间期差值>50ms的百分比(PNN50)较陆上组显著下降(P<0.05)。而两组24h全部窦性心搏R-R间期标准差(SDNN)、24h每5min时段平均间期标准差(SDANN)、相邻R-R间期之间的标准差(SDSD)、三角函数无明显差异。结论常规潜艇水下工作状态对艇员睡眠时的心血管自主神经有明显影响。Objective To study the influence of underwater voyage of conventional submarine on the sinus rhythm and heart rate variability in 24-hour electrocardiogram of the crew.Methods From Mar.2002 to Jul.2009,a total of 242 male naval officers and crew were involved in the present study,of whom 124 were submarine crew（underwater group） and 118 were ground force（control group）.The twelve-lead electrocardiogram analysis system was adopted to record the 24-hour mean heart rate（MHR）,the mean and fastest working heart rate（MWHR,FWHR）,and the mean and lowest sleeping heart rate（MSHR,LSHR）.The heart rate variation（HRV） indexes between the underwater and the control groups were analyzed.Results Compared with the control group,the MSHR and LSHR in underwater group were markedly increased（P〈0.01）,while no significant difference existed between two groups in 24-hour MHR,FWHR and MWHR.Compared the HRV indexes between two groups,the root mean square value of the difference of consecutive R-R intervals（rMSSD）,and the percentage of difference of consecutive R-R intervals 〉50ms（PNN50） in underwater group decreased markedly（P〈0.05）,while no differences existed between the two groups in standard deviation of normal to normal intervals（SDNN）,standard deviation of average normal to normal interval（SDANN）,standard deviation of differences between adjacent R-R intervals（SDSD） and trigonometric functions.Conclusion The routine underwater work condition affects the function of parasympathetic nervous system on the heart and blood vessels in the submarine crew during sleep.

关 键 词：潜水医学 心电描记术 便携式 心率 

分 类 号：R847[医药卫生—航空、航天与航海医学]