389例冠心病患者心率变异性时域指标的分析  

Heart rate variability analysis in patients with coronary artery disease

作　　者：董梅[1] 刘哲[1] 贾恩志[1] 

机构地区：[1]南京医科大学第一附属医院,210029

出　　处：《临床心电学杂志》2015年第3期187-189,共3页Journal of Clinical Electrocardiology

摘　　要：目的探讨心率变异性(HRV)时域指标与冠心病(coronary artery disease,CAD)严重程度之间的关系。方法选取2012年5月至2013年3月期间,在我国伊犁哈萨克自治州友谊医院因疑似或已知冠心病而行冠脉造影的389例患者,纳入本研究。分别行动态心电图和冠状动脉造影检查,依据冠脉造影结果,将患者分为冠心病组和非冠心病组(对照组),比较两组间的心率变异时域指标的差异。随后由冠脉造影结果计算出Gensini评分,依据评分的中位数将冠心病组分为高分组和低分组,对两组间心率变异性指标进行比较,并分别与对照组比较。结果心率变异性时域指标中SDANN和HRV三角指数(TRIA)在冠心病组中较非冠心病组显著降低,两者差异有统计学意义(p<0.05)。SDANN和TRIA在高分组较低分组亦显著降低(p<0.05)。结论心率变异性指标中SDNN和TRIA与CAD的严重程度呈负相关,提示迷走神经功能受损与冠状动脉病变的严重程度呈正相关。Objective To explore the association between time domain analysis of heart rate variability （HRV） and severity of coronary artery disease. Methods A total of 389 adult subjects who would undergo selected coronary angiography for suspected or known coronary heart disease at the Friendship Hospital of Ili Kazakh Autonomous Prefecture were enrolled in the study. A 24-hour ECG Hoher monitoring was performed and a coronary angiography was taken in all the patients before hospital discharge. The subjects＇ HRV and Gensini score were recorded. And all the patients were divided into two groups based on the results of CAD .Variable associated with HRV were then compared between patients with and without coronary artery disease. Also the patients with CAD were divided into two groups. Variable associated with PIRV were compared between patients with high score and patients with low score. and each group was compared with the the control group. Results The indexes of heart rate variability in SDANN, TRIA are different between the patients with CAD and the patients without CAD （p〈0.05）. And SDANN,TRIA remained significantly lower in patients with high score than in patients with low score （p〈0.05）. Conclusions SDANN, TRIA were negatively associated with severity of coronary artery disease that based on Gensini score. The damage of nervi vagus function was positively associated with severity of coronary.

关 键 词：心脏心率变异性 时域分析 冠状动脉疾病 GENSINI评分 

分 类 号：R541.4[医药卫生—心血管疾病] R540.41[医药卫生—内科学]