慢性肺心病患者的心率变异性  

Heart Rate Variability in Patients with Chronic Cor Pulmonale

作　　者：陈绍平[1] 汪淼芹[1] 邹光琼[1] 

机构地区：[1]川北医学院附属医院呼吸内科,四川南充637000

出　　处：《华西医学》2002年第3期329-330,共2页West China Medical Journal

摘　　要：目的 :观察慢性肺心病患者心率变异性 ,了解其自主神经功能的变化。方法 :对 2 5例慢性肺心病、2 5例健康对照者 (对照组 )作前瞻性对照研究 ,记录 2 4h动态心电图 ,作时域和频域分析。结果 :与对照组比较 ,肺心病组相邻心搏的R -R间期之差 >5 0ms的心搏数占R -R间期数的百分比 (pNN5 0 ) ,每 5min正常R -R间期标准差的平均值 (SDANN) ,频域指标的高频 (HF)明显降低 ,低频与高频的比值 (LF/HF)明显升高 ,差异均有非常显著意义 (P均 <0 0 1) ,而频域指标的低频 (LF)无明显变化 (P >0 0 5 )。经过治疗后 ,肺心病组处于缓解期 ,与治疗前比较 ,HF、pNN5 0、SDANN等指标明显增加 ,而LF/HF明显降低 ,差异均有非常显著意义(P均 <0 0 1) ;肺心病组病人治疗后HF、pNN5 0、SDANN等指标均低于对照组 ,而LF/HF明显高于对照组 ,差异均有非常显著意义 (P均 <0 0 1) ;肺心病组治疗后LF与治疗前及对照组比较 ,差异不具显著意义 (P >0 0 5 )。结论 :肺心病患者不仅交感神经活动占优势 ,同时并存迷走神经功能受损 。Obsjective:To observe the changes of autonomic nervous system in patients with chronic cor pulmonale.Methods:Heart rate variability(HRV)was analyzed by short HRV time methods in 25 patients with chronic cor pulmonale in acute attack and in 25 matched healthy adults.Results:The HF?pNN50?SDANN decreased and LF/HF increased in patients with chronic cor pulmonale in acute attack as compared with the controls(P<0.01),while LF decreased(P>0.05).After treatment,the HF?pNN50?SDANN markedly increased and LF/HF decreased in patients with chronic cor pulmonale as compared before treating(P<0.01).The HF?pNN50?SDANN in patients with chronic pulmonary heart disease after treating were lower than those of the controls,LF/HF was higher than that of the normal group(P<0.01).while LF was not markedly changed as compared with the normal group(P>0.05).Conculsion:It was suggested that the patients with chronic cor pulmonale usually with low HRV,marked sympathetic activation and the autonomic dysfuction due to vagal neuropathy.Autonomic nervous dysfuction may existed persisterly.

关 键 词：慢性肺心病 心率变异性 自主神经功能 

分 类 号：R541.5[医药卫生—心血管疾病]