病毒性心肌炎患儿动态心电图时域、频域指标变化与心肌酶学指标的关系  

The change of time—domain and frequency-domain parameters of dynamic electrocardiogram in VMC

作　　者：赵雪然[1] 贺新建[1] 李红艳[1] 牛娅薇 王立娴[1] ZHAO Xue-ran;HE Xin-jian;LIHong-yan;NIU Ya-wei;WANG Li-xian(Functional department,Hebei children's hospital,Hebei 050031,China)

机构地区：[1]河北省儿童医院功能科,石家庄050031

出　　处：《中国急救复苏与灾害医学杂志》2019年第11期1045-1047,共3页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：河北省医学科学研究重点课题计划(20170396)。

摘　　要：目的探讨病毒性心肌炎(viralmyocarditis,VMC)患儿动态心电图检查中时域、频域指标的变化及其与心肌酶学指标的关系。方法受试者均来自河北省儿童医院2016年1月一2018年5月期间就诊的儿童,随机选取符合条件的VMC患儿200例设为VMC组,选取来本院体检的健康儿童100例设为对照组。对比两组患儿动态心电图检查中的时域、频域指标、心肌酶学指标,并探讨其相关性。结果VMC组患儿的总体标准差(standard diviation of NN intervals,SDNN)、均值标准差(standard diviation of average NN intervals,SDANN)显著的低于对照组(P<0.05);VMC组的差值均方根(root mean square of the difference,rMMSD)、差值〉50msRR间期所占的百分比(percent of the number whose difference between adjacent NN interval are more than 50 ms,pNN50)值与对照组比较差异无统计学意义(P>0.05);VMC组患儿的低频功率(low frequency,LF)、高频功率(high frequency,HF)、LF/HF值均显著的低于对照组(P<0.05);VMC组患儿血清肌酸激酶同工酶(creatine kinase MB,CK-MB)、LDH、cTnI、α-HBDH检测水平均显著的高于对照组(P<0.05);VMC组患儿血清CK-MB、乳酸脱氢酶(lactic dehydrogenase,LDH)、心肌肌钙蛋白I(Cardiac troponin I,cTnl)、α-羟丁酸脱氢酶(α-Hydroxybutyrate Dehydrogenase,α-HBDH)检测值与患儿LF、HF、SDNN、SDANN测定值均呈显著的负相关关系(P<0.05)。结论VMC患儿的早期动态心电图的时域及频域指标与心肌酶学指标显著相关,可对患儿心肌损害程度进行早期评价。Objective To investigate the changes of time domain and frequency domain in dynamic electrocardiogram and its relationship with myocardial enzymes in patients with viral myocarditis(VMC).Methods 200 cases(VMC group)and 100 healthy children were selected as the control group from January 2016 to May 2018.The time domain and frequency domain of dynamic electrocardiogram were compared between the two groups Indicators,myocardial enzymes,and to explore their relevance.Results In VMC group SDNN and SDANN were significantly lower than that of control group(P<0.05);VMC group of rMMSD,pNN50 value compared with the control group showed no significant difference(P>0.05);VMC group with LF,HF,LF/HF values were significantly lower than the control group(P<0.05);VMC group CKMB,LDH,cTnl alpha,-HBDH levels were significantly higher than the control group(P<0.05);VMC group CK-MB,LDH,cTnl,-HBDH detection value alpha values showed significant negative correlation with LF,HF and SDNN were determined by SDANN,(P<0.05).Conclusion Early detection of dynamic electrocardiogram in children with VMC and analysis of time and frequency domain indicators can be used for early diagnosis of myocardial damage in children.

关 键 词：病毒性心肌炎 动态心电图 时域 频域 心肌酶学 

分 类 号：R542.21[医药卫生—心血管疾病]