慢性心力衰竭伴室性心动过速患者窦性心律震荡现象的临床观察  

The clinical observation of sinus heart rate turbulence phenomenon for chronic heart failure patients with ventricular tachycardia

作　　者：王春燕[1] 陈霞[1] 侯明桥 甘亮 WANG Chun-yan;CHEN Xia;HOU Ming-qiao;et al(Department of Cardiac Function, First People＇s Hospi- tal of Jiangxia District of Wuhan （Xiehe Jiangnan Hospital of Huazhong University of Science and Technology, Wuhan Fourteenth Hospital, Jiangxia 120 District Emergency Center）, Wuhan 430200, China)

机构地区：[1]武汉市江夏区第一人民医院(华中科技大学协和江南医院、武汉市第十四医院、武汉市江夏区120急救中心)心功能科,湖北省武汉市430200 [2]武汉市江夏区第一人民医院(华中科技大学协和江南医院、武汉市第十四医院、武汉市江夏区120急救中心)心血管外科,湖北省武汉市430200

出　　处：《中国心血管病研究》2018年第4期333-336,共4页Chinese Journal of Cardiovascular Research

摘　　要：目的总结窦性心律震荡现象在慢性心力衰竭伴单纯室早或室性早搏伴心动过速患者治疗中的临床特点。方法将我院2014年1月至2015年1月的70例慢性心力衰竭患者分为室早伴心动过速组和单纯室早组各35例，选取同时段30名有室早现象的健康人作为对照组。观察研究三组入选者震荡初始和震荡斜率的变化，并根据窦性心律震荡的变化程度对其进行分级的临床评估。结果室早伴心动过速组（0．4％比1．7％）和单纯室早组（0．1％比1．7％）的震荡初始值明显低于对照组，震荡斜率明显小于对照组（1．6ms／RRI比7．6ms／RRI，2．4ms／RRI比7．6ms／RRI）；其中室早伴心动过速组的震荡初始值明显大于单纯室早组，震荡斜率明显小于单纯室早组；此外，在窦性心律震荡分级中，对照组集中在0级，单纯室早组集中在1级，室早伴心动过速组则集中在2级，各研究小组数据对比差异具有统计学意义（P〈0．05）。结论慢性心力衰竭患者的窦性心律震荡现象会逐渐得到缓解，室性心动过速患者的窦性心律震荡变化程度比伴室早患者更加显著，且窦性心律震荡的损伤程度可根据其不同分级进行准确的临床判断和评估。Objective To study the clinical characteristics of sinus heart rate turbulence phenomenon during the treatment for patients with chronic heart failure and ventricular premature, ventricular tachycardia. Meth- otis From January 2014 to January 2015, 70 cases of patients with chronic heart failure were divided into prema- ture ventricuiar with group and simple premature ventricular tachycardia, 35 cases at each group. At the same time 30 patients with premature ventricular healthy people as control group. The shock initial and the change of the slope were observed in three groups and were analyzed the according to the changes of the sinus heart rate turbu- lence degree. Results The initial shock value in Premature ventricular tachycardia group （0.4% vs. 1.7% ） and ventricular early group（O.l% vs. 1.7% ） were significantly lower than the control group, heart rate was significantly lower than the control group （1.6 ms/RRI vs. 2.4 ms/RRI vs. 7.6 ms/RRI）; the premature ventricular tachycardia with initial shock group was significantly lower than the rate of ventricular premature group, turbulence slope was significantly less than the simple ventricular premature group; in addition, the heart rate turbulence grading, the control group in 0, ventricular early group concentrated in the 1 stage, premature ventricular tachycardia group concentrated at level 2. The difference of data of each study group was statistically significant （P〈0.05）. Conclu- sion Sinus heart rate turbulence phenomenon will gradually ease in patients with chronic heart failure, the change degree of sinus heart rate turbulence in patients with ventricular tachycardia is more significant than patients with premature ventricular, and the damage degree of sinus heart rate turbulence can be accurately judged and evaluat-ed according to the different classification.

关 键 词：慢性心力衰竭 室性心动过速 窦性心律震荡 

分 类 号：R541.6[医药卫生—心血管疾病]