正常人心率减速力与心率变异性的关系  

Day vs night heart rate deceleration capacity and heart rate variability patterns in healthy adults

作　　者：杨晓云[1] 左萍[1] 刘鸣[2] 樊静静[1] 王铁锚[1] 余彦[1] 李莉[1] 曾艳[1] 吴杰[1] 

机构地区：[1]华中科技大学同济医学院,43003 [2]武汉亚洲心脏病医院,430022

出　　处：《临床心电学杂志》2011年第4期264-266,共3页Journal of Clinical Electrocardiology

摘　　要：目的观察健康人心率减速力（DC）和心率加速力（AC）的昼夜变化规律及其与心率变异性（HRV）之间的关系。方法 80例健康人接受24h动态心电图检查,按其时间段不同而划分为昼间（15：00~20：00）和夜间（00：00~05：00）两个时间段。计算机自动测定其昼夜24h的DC、AC值及心率变异性时域指标（SDNN,RMSSD）与频域指标（LF、HF）;比较昼间和夜间不同时间段的DC和AC值,并观察昼夜24h的DC及AC值与HRV各指标之间的关系。结果夜间的DC值与昼间相比明显增大（7.98±3.14msvs.5.70±2.28ms,p=0.0004）;夜间的AC值与昼间相比也有明显的差异（-6.88±3.32msvs.-8.85±3.90ms,p=0.0184）。24h的DC值与心率之间呈明显的负相关关系,与SDNN、RMSSD、LF和HF之间呈明显的正相关关系;24h的AC值与心率之间呈明显的正相关关系,而与SDNN、RMSSD、LF和HF之间呈明显的负相关关系。结论正常人的DC与AC值存在着昼夜变化规律,但两者的变化程度并不对等,主要以DC变化为主。DC可以定量评估受检者迷走神经张力的变化,是一项可靠的检测自主神经张力的新技术。Objective To assess the heart rate deceleration capacity（DC）, aceleration capacity（AC） and their association with heart rate variability（HRV） in 80 health adults, and investigate DC as a way for determination of cardiac autonomic nervous function. Methods Using 24h Holte recordings, DC, AC, time and frequency domain parameters of HRV were obtained from 80 health adults in the daytime （15：00~20：00） and at night （00：00~05：00） respectively. Results It was found that the values of DC were increased at night than those in the daytime （7.98±3.14ms vs. 5.70±2.28ms, p=0.0004）. There was a significant difference between AC in the daytime and at night （-6.88±3.32 ms vs.-8.85±3.90ms, p=0.0184）. Significant negative correlation between DC and HR, positive correlation between DC and SDNN、RMSSD、LF、HF were observed. There were positive correlation between AC and HR, negative correlation between AC and SDNN、RMSSD、LF、HF. Conclusion There are circadian variations of DC and AC in healthy adults, but the degree of the change is not accordant, mainly of DC. DC can quantitatively assess the diurnal variation of the vagal tone and should be considered as a better way for determination of cardiac autonomic nervous function.

关 键 词：心率减速力 心率变异性 昼夜变化 

分 类 号：R540.41[医药卫生—心血管疾病] R541.7[医药卫生—内科学]