冠心病早搏发生频度相关多因素分析  

Correlative multifactor analysis on frequency of ventricular premature beats in coronary heart disease

作　　者：刘兵[1] 贾国良[1] 郭文怡[1] 陈兰芳[1] 

机构地区：[1]第四军医大学西京医院心脏内科,西安710033

出　　处：《第三军医大学学报》2001年第5期591-592,共2页Journal of Third Military Medical University

摘　　要：目的　采用心率变异性 (HRV)、左室射血分数 (LVEF)及临床背景资料对冠心病室性心律失常进行危险预测的研究。方法　 81例冠心病患者分为VPBs≥ 30 /h组及VPBs <30 /h组 ,分别测量HRV指标、LVEF及临床资料。结果　两组间年龄、血压差异无显著性 ,VPBs≥ 30 /h组的LVEF、SDNN、SDANN及HRVI均显著低于VPBs <30 /h组 (分别为 43 .2 9± 15 .38比 6 7.33± 11.47,P <0 .0 1;90 .0 5± 2 2 .2 9比 117.90± 30 .32 ,P <0 .0 5 ;77.43± 17.78比 10 5 .6 9± 2 8.79,P <0 .0 5 ;2 4.5 4± 8.70比 32 .70± 10 .87,P <0 .0 5 ) ,VPBs≥ 30 /h组心肌梗塞发生率显著高于VPBs <30 /h组。Logistic多因素回归分析表明LVEF是预测室性心律失常危险性的独立因素 (B =0 .119,P =0 .0 32 )。结论　本研究表明LVEF是冠心病室性心律失常的独立危险因素。虽然HRV指标、心肌梗塞病史对VPB无独立判别意义 ,但在两组间差异显著 ,临床上筛选高危病例时 ,应同时综合考虑这些指标 ,以提高高危病例的成功筛选。Objective To investigate the prognosis in risk of ventricular arrhythmia in coronary heart disease with heart rate variability (HRV), left ventricular ejection fraction (LVEF) and other clinical background data. Methods A total of 81 patients were divided into ventricular premature beats (VPBs)≥30/h group and VPBs<30/h group. Their LVEF, HRV and clinical data were studied and analyzed. Results The age and blood pressure between 2 groups had no significant difference. LVEF, standard deviation of all normal RR intervals (SDNN), SD of the average of NN interval (SDANN) and HRV triangular index (HRVI) were significant less in VPBs≥30/h group than in VPBs<30/h group (43.29±15.38 vs 67.33 ±11.47, P <0.01;90.05±22.29 vs 117.90±30.32, P <0.05;77.43±17.78 vs 105.69±28.79, P <0.05;24.54±8.70 vs 32.70± 10.87 , P <0.05, respectively). Incidence of myocardial infarction (MI) was larger in VPBs≥30/h group than VPBs<30/h group. LVEF was the independent predictable factor in risk of ventricular arrhythmia with multinomial regression logistic analysis( B =0.119, P =0.032). Conclusion Our findings indicate that LVEF is an independent predictable factor in risk of ventricular arrhythmia in coronary heart disease. Although HRV and MI history can not be used to predict VPB, significant difference is found between 2 groups. High risk patients could be selected successfully when these data are considered in combination.

关 键 词：冠心病 室性心律失常 危险性 射血分数 心率变异性 早搏 HRV LVEF 

分 类 号：R541.4[医药卫生—心血管疾病]