心功能分级与心率变异性的相关性研究  

Study on the correlation between cardiac functional grading and heart rate variability in patients with cardiac insufficiency

作　　者：刘伟[1] 邢新颖 张晨峰[1] 宋达[2] 张明[3] 韩刚[5] LIU Wei;XING Xinying;ZHANG Chenfeng(The Third Department of Cardiovascular Medicine,The First Central Hospital of Baoding city,Hebei,Baoding 071000,China)

机构地区：[1]河北省保定市第一中心医院心内三科,071000 [2]河北省保定市第一中心医院心内二科,071000 [3]河北省保定市第一中心医院心内四科,071000 [4]中国人民解放军陆军第82集团军医院麻醉科 [5]中国人民解放军陆军第82集团军医院泌尿外科

出　　处：《河北医药》2019年第13期1940-1944,共5页Hebei Medical Journal

基　　金：保定市科学技术研究与发展计划(编号:18ZF255)

摘　　要：目的探讨纽约心脏病学会(NYHA)心功能分级与心率变异性的关系,明确自主神经变化规律,为进一步观察治疗及指导预后提供参考。方法86例心功能不全患者用NYHA心功能分级为Ⅱ、Ⅲ、Ⅳ级分别纳入A组(n=36)、B组(n=28)、C组(n=22),行动态心电图检查得出各项时域指标[R-R间期的标准差(SDNN)、R-R间期均值的标准差(SDANN)、相邻R-R间期差值的均方根(RMSSD)、相差在50ms的RR间期的数量占所有RR数量的比例(PNN50)],同时观察3组患者临床指标。结果3组体重指数、收缩压、舒张压、吸烟和饮酒情况比较,差异无统计学意义(P>0.05)。B、C组SDNN、SDANN、RMSSD、PNN50均低于A组,且C组低于B组,差异境外有统计学意义(P<0.05)。结论冠心病中心功能不全较重的患者自主神经功能受损更严重,应根据心率变异性变化情况积极改善患者自主神经功能,从而降低冠心病并发症的发生率及改善患者预后。Objective To investigate the relationship between the cardiac function classification and heart rate variability to identify the autonomic nerve change rule,in order to provide reference for further observation treatment and prognosis evaluation as well as new treatment strategies. Methods A total of 86 patients with cardiac insufficiency were enrolled in the study,according to New York cardiac functional grading criterion,who were classified as group A(cardiac function Ⅱ,n = 36),group B(cardiac function Ⅲ,n = 28),group C(cardiac function Ⅳ,n = 22). The dynamic electrocardiogram was used to detect the time domain indexes automatically. Results There were no significant differences in BMI,systolic pressure,diastolic pressure,smoking,alcohol drinking among the three groups(P > 0. 05). The levels of SDNN,SDANN,RMSSD,PNN50 in group B and group C were significantly lower than those in group A,moreover,which in group C were significantly lower than those in group B(P < 0. 05). Conclusion The patients with severer cardiac insufficiency due to coronary heart disease have severer autonomic nerve function damage,it is necessary to improve autonomic nervous function of patients positively so as to reduce the incidence of coronary heart disease and improve patient’s prognosis.

关 键 词：心率变异性 心功能不全 自主神经功能 动态心电图 

分 类 号：R540.41[医药卫生—心血管疾病]