冠心病患者窦性心率震荡及T波电交替与心率变异性的相关性分析  

Analysis of the Correctlation between HRT,TWA and HRV in Patients with Coronary Heart Disease

作　　者：潘婷婷[1] 李郁[1] 

机构地区：[1]浙江医院心电诊断科,310013

出　　处：《心脑血管病防治》2012年第4期272-274,283,共4页CARDIO-CEREBROVASCULAR DISEASE PREVENTION AND TREATMENT

摘　　要：目的探讨冠心病患者窦性心率震荡(HRT),心率变异性(HRV)及T波电交替(TWA)变化及相关性。方法冠状动脉造影诊断为冠心病患者(冠心病组)137例,其中陈旧性心肌梗死组50例,稳定性心绞痛组87例;选择同期健康体检者101例为对照组。24h动态心电图检测各组HRT、HRV和TWA参数,进行相关性分析。结果冠心病组与对照组比较,TO值显著增高,TS值显著下降,HRV指标(SDANN,ASDNN,VLF,LF,TP,LF/HF)值显著下降,差异有统计学意义(均P<0.01);最大TWA值增大,在MV5,MV1导联差异有统计学意义(均P<0.01)。陈旧性心肌梗死组与稳定性心绞痛组比较,TS值显著下降,HRV指标(SDANN,ASDNN,VLF、LF、HF、TP)值显著降低,差异有统计学意义(均P<0.05)。TO与SDNN、ASDNN、VLF呈负相关(r=-0.18^-0.19,P<0.05),TS与VLF、LF、HF、TP、SDANN、ASDNN、rMSSD、PNN50呈正相关(r=0.22~0.46,均P<0.01)。结论同时对HRT、HRV及TWA参数比对评估,可提高对冠心病患者危险性评估的准确性和可靠性。Objective To explore the colTelation between HRT, TWA and HRV in patients with coronary heart disease. Methods 101 nomral healthy controls and 137 patients with coronmy heart disease classified into 2 subgroups： 50 patients of OMI, 87 patients of stable angina pectoris were enrolled in this study. The 24-hour holter monitor was used to calculate HRT, TWA and HRV parameters. Results Compared with control group, TO was significantly increased and TS was decreased. HRV paramete （SDANN, ASDNN, VLF, LF, TP, LF/HF） were significantly decreased （all P 〈 0.01） ; The Max TWA parameters were significantly increased in lead MV5 and MV1 （all P 〈 0.01 ） in CHD group. Compared with stable angina pectoris group,TS was significantly decreased, HRV pa- ramete （SDANN, ASDNN, VLF, LF, TP） were significantly decreased （all P 〈 0.05） in OMI group. TO was negatively correlal- edwith SDNN, ASDNN and VLF （r= - 0.18 - 0.19, P 〈 0.05）, TS was positively correlated with VLF, LF, HF, TP, SDANN, ASDNN, rMSSD and PNN50 （r= 0.22- 0.46, all P 〈 0.01）. Conclusions Take a contrast assessment for parameters of HRT, TWA and HRV at the same time, it can improve the accuracy and reliability of prognosis assessment in patients with coronary heart disease.

关 键 词：冠心病 窦性心率震荡 心率变异性 T波电交替 

分 类 号：R541.4[医药卫生—心血管疾病]