0～14岁正常儿童心率变异性分析  

Analysis of heart rate variability of 0～14 years old healthy children

作　　者：李敏[1,2] 王健怡[1,3] 刘万红[1,2] 秦丽[1,2] 黄敏[1,3] 

机构地区：[1]上海市儿童医院 [2]上海交通大学附属儿童医院新生儿科,上海200040 [3]上海交通大学附属儿童医院心内科

出　　处：《临床心血管病杂志》2011年第5期374-376,共3页Journal of Clinical Cardiology

摘　　要：目的：探讨0-14岁正常儿童心率变异性（HRV）的特点及时域指标值范围。方法：对2 230例正常儿童进行24 h全程动态心电图记录,对24 h窦性心律进行HRV的时域分析,时域分析的指标包括：SDNN、SDANN、SDNN index、rMSSD、PNN50。按年龄顺序将2 230例儿童分为5组：新生儿组（371例）,婴儿组（53例）,幼儿组（157例）,学龄前组（366例）,学龄组（1 283例）。按相邻各组之间的HRV参数进行比较分析,并与欧美成人正常参考值比较分析。结果：婴儿组、幼儿组、学龄前组、学龄组与新生儿组的SDNN、SDANN、SDNN index、rMSSD、PNN50均差异有统计学意义,HRV各时域的多数参数随年龄的增加而增大;②新生儿组、婴儿组、幼儿组男女性别间HRV各时域指标值无差异,学龄前组男女性别间SDNN、SDANN、SDNN index差异有统计学意义,学龄组男女性别间HRV的5项时域指标值均差异有统计学意义;③本资料均值与欧美成人正常参考值间差异有统计学意义。结论：儿童HRV多数时域值随年龄的增加而增大,表明儿童自主神经系统发育未臻成熟,交感-副交感神经失衡,随年龄的增加渐趋成熟,学龄前组至学龄组男女性别间心脏自主神经发育不一致。Objective：To assess the normal range of the time-domain index of heart rate variability（HRV） in healthy children from 0~14 years old.＂ Method：Continuous electrocardiographic monitorization by 24-hour Holter recordings was performed in 2230 healthy children to analyze the difference of HRV with sinus rhythm.Time-domain indexs included SDNN SDANN SDNN index rMSSD and PNN_50.Two thousand and two hundred and thirty healthy children were divided into 5 groups according to their ages as group 1,n=371,1 month old;group 2,n=53,1 month-1 year old;group 3,n=157,1-3 years old;group 4,n=366,3-6 years old;group 5,n=1283,6-14 years old.HRV was analyzed and compared among different groups and compared to the normal level of adults in Western.Result：①Significant differences of SDNN SDANN SDNN index RMSSD PNN_50 were found in different groups.Time-domain indexs increased with age.②No difference were shown between male and female in group 1,2 and 3.SDNN,SDANN and SDNN index changed significantly between male and female in group 4 and 5.③Significant differences were found between our results and the normal lelves of Western adults.Conclusion：Time-domain index increased with age.Significant differences in HRV between male and female in group 4 and 5 suggest the variance in the development of autonomic nervous system between male and female.HRV indicates the activity of autonomic nervous system and risk factor of several diseases.It is important to establish normal range of HRV in children with different ages.

关 键 词：儿童 心率变异性 自主神经 

分 类 号：R339.31[医药卫生—人体生理学]