窦性心率震荡现象与冠状动脉病变的相关性研究  

Clinical research about the correlation between coronary artery disease and heart rate turbulence

作　　者：殷洪山[1] 苏瑞瑛[1] 邰炜彦[1] 孙平[1] 姜志安[1] 赵娟[1] 王涛[1] 

机构地区：[1]河北医科大学第三医院,石家庄市050051

出　　处：《河北医药》2011年第5期648-650,共3页Hebei Medical Journal

基　　金：河北省医学科学研究重点课题(编号:08325)

摘　　要：目的探讨窦性心率震荡现象与冠心病患者冠状动脉病变严重程度的相关性关系。方法将68例患者按冠状动脉造影结果分为冠心病组46例和对照组22例,对照组无狭窄或狭窄<50%,冠心病组先按血管狭窄程度分为2组:狭窄组(狭窄50%～99%),阻塞组(完全闭塞),然后根据主要冠状动脉受累数分为单支病变组和多支病变组。每例患者均做24h动态心电图检查,获得心率震荡(HRT)参数:震荡初始(TO)和震荡斜率(TS),同时获取心率变异(HRV)的时域性指标:(1)24h全部正常窦性R-R间期标准差(SDNN);(2)24h内每5分钟时间段窦性R-R间期平均值的标准差(SDANN)。比较冠心病组、对照组不同TO、TS、SDNN、SDANN值。结果冠心病患者与对照组比较TO值增高(P<0.01),TS值下降、SDNN、SDANN值减少(P<0.01);冠脉狭窄程度越重,病变范围越大,TO越高、TS及SDNN、SDANN就越低。结论冠心病患者HRT的异常与冠状动脉病变范围、狭窄程度有关,提示HRT对冠状动脉病变范围、狭窄程度评价有一定的临床意义。Objective To investigate the correlation between heart rate turbulence（HRT） and coronary artery disease（CAD）.Methods 68 patients were divided into coronary disease group（n=46） and control group（n=22） according to the examination results by coronary angiography.The coronary disease group was subdivided different groups according to the angiostegnosis degree and the vessel number that was damaged.All the patients underwent 24-hour Holter to collect HRT parameters：TO,TS and heart rate variability（HRV）,SDNN,SDANN,then these parameters were compared between the coronary disease group and the control group.Results There was a significant increase in TO,and a decrease in TS,SDNN and SDANN in patients with CAD（P0.01）,and the more severe the coronary stenosis degree was,the greater the range of coronary pathological changes,however,the higher the TO was,the lower the TS,SDNN and SDANN.Conclusion The abnormality of HRT in patients with coronary heart disease is correlated with the range and narrow degree of coronary artery pathological changes,which suggets that HRT has a certain clinical significance in the evaluation of the range and narrow degree of coronary artery pathological changes.

关 键 词：冠状动脉狭窄 冠状动脉造影 心率震荡 心率变异性 

分 类 号：R543.3[医药卫生—心血管疾病]