窦性心率震荡对室性早搏儿童的风险预测价值  

The Value of Heart Rate Turbulence on the Risk Evaluation of Premature Ventricular Contraction in Children

作　　者：林瑶[1] 石琳[1] 郑彤[1] 刘艳[1] 赵地[1] 梁璐[1] 张明明[1] 刘杨[1] 

机构地区：[1]首都儿科研究所附属儿童医院,100020

出　　处：《临床心电学杂志》2016年第3期208-211,共4页Journal of Clinical Electrocardiology

基　　金：首都儿科研究所所级课题(所-13年-B04)

摘　　要：目的探讨窦性心率震荡（heart rate turbulence,HRT）对室性早搏儿童发生终点事件的风险预测价值。方法将71例未经治疗的室性早搏儿童分为心源性疾病组（A组）、良性室性早搏组（B组）。采用12导联动态心电图分析仪对各组患儿HRT,包括震荡初始（Turbulence Onset,TO）和震荡斜率（Turbulence slop,TS）进行自动分析,并记录是否发生终点事件,对数据进行统计分析。结果 A组TO较B组高（-0.019±0.025vs-0.029±0.045）,A组TS较B组略低（5.84±6.06 ms/RR vs 6.01±6.57 ms/RR）,但无统计学差异（t=-1.040,p=0.302;t=0.118,p=0.906）。12例（16.9%）患儿发生终点事件,均为A组患儿,A组内9例TO异常者,发生终点事件7例,明显高于TO正常者（77.8%vs 23.8%,χ~2=5.562,p=0.018）。71例患儿TO异常者21例,其终点事件发生率亦高于正常者（33.3%vs 10.0%,χ~2=4.192,p=0.041）。结论儿童心源性疾病时HRT现象减弱,TO异常者发生终点事件的几率升高,提示HRT对于合并室性早搏的器质性心脏病及终点事件具有预测意义,且无创易行,可于临床推广。Objective To investigate the value of heart rate turbulence（HRT） on the risk evaluation of endpoint event in children with premature ventricular contraction（PVC）. Methods Seventy-one children were enrolled who were diagnosed as PVC without treatment in Capital Institute of Pediatrics, Beijing, China. These children were divided into 2 groups according to different causes of disease, including cardiovascular disease group（group A） and benign PVC group（group B）. All children accepted 24 h dynamic electrocardiogram by DMS Net 12-lead ECG data analyzer to record their HRT data, including turbulence Onset（TO） and turbulence slop（TS）. At the same time,endpoint events were recorded. All data were collected as standard procedure and analyzed using statistic methods.Results Compared with children in group B, children in group A had a higher average TO（-0.019±0.025 vs-0.029±0.045, t=-1.040, p=0.302）and a lower TS（5.84±6.06 ms/RR vs 6.01±6.57 ms/RR, t=0.118, p=0.906）, But the difference was not statistically significant. There were 12 children（16.9%）who suffered endpoint events in all 71 children. All these 12 children belonged to group A. In Group A, patients with abnormal TO had a higher rate of endpoint events than those with normal TO（77.8% vs 23.8%,χ~2=5.562, p=0.018）. In 71 children, there was also a higher rate of endpoint events in patients with abnormal TO（33.3% vs 10.0%,χ~2=4.192, p=0.041）. Conclusions The phenomenon of HRT was weakened in patients with some cardiac diseases such as myocarditis and cardiomyopathy, and patients with abnormal TO were in a higher risk of endpoint events, which indicated that HRT had predictive value to PVC in children. Furthermore, the analysis of HRT is easy and feasible to apply in clinic.

关 键 词：室性早搏 儿童 窦性心率震荡 室性心动过速 终点事件 

分 类 号：R725.4[医药卫生—儿科]