心率变异性对器质性心脏病患者室性心律失常的预测价值  

The predictive value of heart rate variability to, and its correlation with ventricular arrhythmias in patients with structural heart disease

作　　者：葛郁芝[1] 熊力娟[1] 王云霞[1] 吴志婷[1] 张淑华[1] 刘秋玲[1] 刘艳阳[1] 

机构地区：[1]江西省人民医院心内科江西省心血管病研究所,南昌330006

出　　处：《中华老年医学杂志》2014年第11期1161-1163,共3页Chinese Journal of Geriatrics

基　　金：国家自然基金项目（81260031）;江西省卫生厅科技支撑计划（20123010）

摘　　要：目的 探讨心率变异性时域指标在器质性心脏病患者中对室性心律失常发生的预测价值及其相关性分析. 方法 对2012年3月至2013年10月来我院行动态心电图的300例患者的24 h动态心电图的心率变异性时域指标R-R间期的标准差（SDNN）、频域指标交感与迷走比值和心律失常数据进行回顾性分析. 结果 器质性心脏病患者SDNN＜100 ms时室性心律失常发生率较无器质性心脏病SDNN＞ 100 ms者增高,为39.5％（45/114）比4.1％（3/74）,差异有统计学意义（P＜0.01）.器质性心脏病伴室性心律失常患者交感神经与迷走神经张力比值较无室性心律失常、无器质性心脏病者增高（19.9±2.3比10.1±1.7）（P＜0.01）.时域指标SDNN与频域指标交感神经与迷走神经张力比值变化呈负相关（r=-0.819,P＜0.01）. 结论 SDNN＜100 ms、交感神经与迷走神经张力比值增高可作为器质性心脏病患者发生室性心律失常的预测指标.Objective To investigate the predictive value of heart rate variability to,and its correlation with ventricular arrhythmias in patients with structural heart disease.Methods 24 hours ambulatory electrocardiogram monitoring was administered during March 2012 and October 2013,and standard deviation of the NN interval （SDNN） in the time-domain analysis and sympathetic/vagal ratio in the frequency domain analysis were collected and retrospectively analyzed in 300 patients.Results The incidence rate of ventricular arrhythmias was higher in patients with structural heart disease in SDNN ＜100 ms group than in control group [4.1％ （3/74） vs.39.5％ （45/114）,P＜0.01].The sympathetic/vagal ratio was significantly higher in group with structural heart disease and ventricular arrhythmia than in control group（19.9 ±2.3 vs.10.1 ±1.7,P＜0.01）The time-domain index SDNN was negatively correlated with the frequency domain index （sympathetic/vagal ratio） （r=-0.819,P ＜0.01）.Conclusions SDNN ＜100ms and the increased sympathetic/vagal ratio can be considered as the predictors of ventricular arrhythmias in patients with structural heart disease.

关 键 词：心律失常 心性 心率 

分 类 号：R541.7[医药卫生—心血管疾病]