老年心房颤动脑栓塞和非杓型心率的关系  

Relationship between aged cerebral embolism from atrial fibrillation and non-dipper heart rate

作　　者：杜红瑜 张克宁[1] 俞晓燕[1] 

机构地区：[1]南京大学医学院附属鼓楼医院心血管内科心功能室,江苏南京210008

出　　处：《心血管康复医学杂志》2016年第2期147-149,共3页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:探讨非杓型心率与老年心房颤动脑栓塞严重程度的关系。方法:对95例老年持续性心房颤动脑栓塞患者于入院24h内行24h动态心电图(Holter)监测,根据监测结果,患者被分为杓型心率组(21例)、非杓型心率组(56例)、反杓型心率组(18例),同期采用美国国立卫生研究院卒中量表(NIHSS)对三组患者进行神经功能缺损程度评分,对患者心率与NIHSS评分的关系进行回顾性分析。结果:与杓型心率组比较,非杓型心率组和反杓型心率组的平均心率[(83.09±8.06)次/min比(89.09±7.83)次/min比(95.50±8.06)次/min]和NIHSS评分[(5.14±2.65)分比(7.95±5.30)分比(11.11±7.41)分]均显著升高,且反杓型心率组的显著高于非杓型心率组(P<0.05或<0.01)。结论:心率的昼夜变化异常可以加重老年心房颤动脑栓塞患者的病情,在常规治疗基础上,需同时关注心率昼夜节律性的调节。Objective：To explore the relationship between non-dipper heart rate（HR）and severity of cerebral embolism from atrial fibrillation in aged patients.Methods：A total of 95 aged patients with persistent atrial fibrillation complicated cerebral embolism received 24 h Holter monitoring within 24 hafter hospitalization.According to 24 h Holter monitoring results,patients were divided into dipper HR group（n=21）,non-dipper HR group（n=56）and reverse dipper HR group（n=18）.United States national institutes of health stroke score（NIHSS）was used to evaluate neurological deficit severity of three groups,and the relationship between HR and NIHSS score was retrospectively analyzed.Results：Compared with dipper HR group,there were significant rise in mean HR [（83.09±8.06）beats/min vs.（89.09±7.83）beats/min vs.（95.50±8.06）beats/min]and NIHSS score [（5.14±2.65）scores vs.（7.95±5.30）scores vs.（11.11±7.41）scores]in non-dipper HR group and reverse dipper HR group,and those of reverse dipper HR group were significantly higher than those of non-dipper HR group,P〈0.05or0.01.Conclusion：Abnormal circadian changes of heart rate can aggravate patient＇s condition in aged patients with atrial fibrillation complicated cerebral embolism.So based on routine treatment,regulation of circadian rhythm of heart rate should also be noticed.

关 键 词：心率 昼夜节律 颅内栓塞 心电描记术 便携式评价 

分 类 号：R541.75[医药卫生—心血管疾病]