特发室性早搏患者窦性心率震荡的分析  

Analysis of Heart Rate Turbulence in Patients with Idiopathic Premature Ventricular Contractions

作　　者：邓伟[1] 谭珍妮[1] 孙少喜[1] 罗苑苑[1] 李蘅[1] 许顶立[1] 彭健[1] 

机构地区：[1]南方医科大学南方医院心内科,广东广州510515

出　　处：《医学临床研究》2010年第2期193-195,共3页Journal of Clinical Research

基　　金：广东省科技计划项目（编号：2008B030301142）;南方医院新业务新技术院级课题（编号：2008009）

摘　　要：【目的】观察分析特发室性早搏患者窦性心率震荡（HRT）的变化及临床意义。【方法】239例特发室性早搏患者按早搏负荷分为三组：低负荷组80例（室早负荷〈1％）、中负荷组77例（室早负荷≥1％且〈10％）和高负荷组82例（室早负荷≥100），比较各组间HRT参数，震荡初始（T0）和震荡斜率（TS）的差异并分析HRT异常与早搏负荷之间的关系。【结果】随着早搏负荷的增大，特发室性早搏患者HRT异常的发生率明显增加（低、中、高三组HRT异常率分别为：13．7％、18．2％、37．8％，P〈0．01），TO值明显增大（低、中、高三组分别为：－2．04±1．62％、－1．37±1．26％、-0．57±1．59％，P〈0．01），TS值逐渐降低（低、中、高三组分别为：3．72±1．01ms／RR、3．15±0．83ms／RR、2．75±0．58ms／RR，P〈0．01）。HRT异常与早搏负荷呈明显正相关（P〈0．01），TO值与早搏负荷呈明显正相关（P〈0．01），而TS值与早搏负荷呈负相关（P〈0．01）。【结论】特发室性早搏患者HRT现象随早搏负荷的增大而减弱，心率震荡异常与早搏负荷明显相关，过大的早搏负荷可能影响特发室性早搏患者心脏自主神经功能。[Objective]To study the change of heart rate turbulence（HRT） in patients with idiopathic premature ventricular contractions（IPVCs） and its clinical significance. [Methods]A total of 239 patients with IPVCs were divided into three groups by contraction burden： lower group （ n = 80, burden〈 1%）, moderate group（n =77, burden≥l% and G10%） and high group（n ：82, burden≥10%）. Two HRT parameters such as turbulence onset（TO） and turbulence slope（TS） were measured by using digitized 24h Holter recordings. The incidence of abnormal HRT,two HRT parameters and their correlations with the contraction burden were compared among three groups. [Results]As contraction burden increased, the incidence of abnormal HRT significantly increased among three groups which those of lower, moderate and high groups were 13.7%, 18. 2% and 37.8%, respectively（ P 〈0.01）. The value of the TO was significantly higher and the value of the TS was significantly lower among three groups（ P 〈0.01）. Significant positive correlation between the incidence of abnormal HRT and contraction burden, TO and contraction burden, and negative correlation between TS and contraction burden were observed（ P 〈0.01）. [Conclusion]As contraction burden increases, HRT becomes weak in the patients with IPVCs, and the incidence of abnormal HRT is strongly correlated with contraction burden. Excessive contraction burden may affect the cardiac autonomic nerve function in patients with IPVCs.

关 键 词：心脏复合征 早搏 心率 

分 类 号：R541.7[医药卫生—心血管疾病]