心率变异性分析在先天性心脏病合并阵发性室上性心动过速患儿中的意义  

The significance of heart rate variability analysis in children with congenital heart disease combined with paroxysmal supraventricular tachycardia

作　　者：彭静[1] 王瑞耕[1] 刘玲[1] 孙东明[1] 龙元[1] 

机构地区：[1]武汉市妇女儿童医疗保健中心心血管内科,湖北武汉430016

出　　处：《临床儿科杂志》2016年第7期486-488,共3页Journal of Clinical Pediatrics

摘　　要：目的探讨自主神经系统活动在先天性心脏病（CHD）息儿阵发性室上性心动过速（PSVT）发生中的作用。方法选择无CHD的PSVT患儿50例（PSVT组）、伴CHD的PSVT患儿30例（伴CHD组）及同期健康儿童50例（对照组），回顾性分析、比较三组患儿24h心率变异性（HRV）长程时域指标的差异。结果各项HRV长程时域指标即NN间期标准差（SDNN）、NN间期均值标准差（SDANN）、NN间期标准差均值（SDNNIndex）、NN间期差值个数百分比（pNN50）、相邻NN间期差值均方根值（RMSSD）在三组间的差异有统计学意义（F=80．32～263．18，P均〈0．01）。与对照组比较，PSVT组的SDNN、pNN50、RMSSD均下降，差异有统计学意义（P〈0．05）ISDANN、SDNNIndex虽有下降，但差异无统计学意义（P均〉0．05）。伴CHD组与PSVT组比较，SDNNIndex、pNN50及RMSSD下降，差异有统计学意义（P均〈0．05），SDNN、SDANN下降差异有统计学意义（P均〈0．01）。SDNN、pNN50、RMSSD、SDANN、SDNNIndex在伴CHD组与对照组两组间比较差异有统计学意义（P均〈0．01）。结论PSVT患儿存在自主神经系统的失衡，以迷走神经功能降低为主，而伴CHD的PSVT患儿同时存在交感神经张力增高。Objective To explore the function of autonomic nerves system in children with congenital heart disease （CHD） combined with paroxysmal supraventricular tachycardia （PSVT）. Methods Fifty children having PSVT and no CHD （PSVT group）, 30 children with both PSVT and CHD （CHD group）, and 50 cases of healthy children （control group） were selected. The difference of 24-hour heart rate variability （HRV） among three groups was analyzed retrospectively. Results There were statistical differences in the long-range time domain HRV indexes, including SDNN, SDANN, SDNN Index, pNN 50 , and RMSSD among three groups （F=80.32-263.18, P all〈0.01）. The SDNN, pNN50, and RMSSD in PSVT group were significantly decreased compared with control group （P all〈0 . 05 ）, and the SDANN and SDNN Index in PSVT group were decreased but the difference was not statistically significant compared with control group （P all〉0.05）. The SDNN, SDANN, SDNN Index, pNN50, and RMSSD were signiifcantly decreased in CHD group compared with PSVT group （P all〈0 . 05 ）. Conclusions Children with PSVT have the imbalanced autonomic nerves system which mainly manifests as decreased vagal function, and, if combined with CHD, have the increase of sympathetic nerve tension.

关 键 词：先天性心脏病 心率变异性 阵发性室上性心动过速 儿童 

分 类 号：R725.4[医药卫生—儿科]