不同程度亚临床甲减患者的心率变异性及心律失常分析  

Analysis of Heart Rate Variability and Arrhythmia in Patients with Different Degrees of Subclinical Hypothyroidism

作　　者：李姣 杨健威[1] 李海珍[1] 韦巍[1] 

机构地区：[1]广西中医药大学第一附属医院,广西南宁530021

出　　处：《大众科技》2020年第10期46-48,共3页Popular Science & Technology

基　　金：广西壮族自治区卫生和计划生育委员会自筹经费科研课题立项项目(Z20170286)。

摘　　要：目的:通过亚临床甲减患者不同促甲状腺激素(TSH)水平状态下的心率变异性及心律失常分析,了解不同程度亚甲减患者自主神经功能状态。方法:选取55例亚临床甲减患者根据TSH水平分为两组:亚甲减1组(TSH 4.2-10 uIU/mL)29例、亚甲减2组(TSH>10 uIU/mL)26例,同期健康体检者29例作为对照组(TSH 0-4.2 uIU/mL),所有患者安装24小时动态心电监测仪。24小时后回放数据,分析心律失常及心率变异性(HRV)各项指标。结果:SDNN、SDANN、PNN50、LF、HF亚甲减组低于对照组,SDNN、SDANN、LF、HF指标三组经方差分析差异有统计学意义,逸博及逸博心律对照组与亚甲减组差异有统计学意义。结论:亚临床甲减患者随着TSH水平升高,心率变异性(HRV)下降明显,提示亚甲减患者自主神经对心脏调节作用的平衡力减弱,主要表现为交感神经张力增高及迷走神经张力下降。Objective:To analyze the heart rate variability and arrhythmia of patients with subclinical hypothyroidism under different levels of thyroid stimulating hormone(TSH),so as to understand the autonomic nervous function of patients with different degrees of hypothyroidism.Methods:55 patients with subclinical hypothyroidism were divided into two groups according to TSH level:29 cases in hypothyroidism group 1(TSH 4.2-10 uIU/mL),26 cases in hypothyroidism group 2(TSH>10 uIU/mL),and 29 healthy persons in the same period as the control group(TSH 0-4.2 uIU/mL).All patients were installed with 24-hour ambulatory ECG monitor.After 24 hours,the data were replayed to analyze the indexes of arrhythmia and heart rate variability(HRV).Results:SDNN,SDANN,PNN50,LF,HF in the hypothyroidism group were lower than those in the control group.The differences of SDNN,SDANN,LF and HF indexes among the three groups were statistically significant by analysis of variance,and the differences of escape and escape rhythm between the control group and the hypothyroidism group were statistically significant.Conclusion:Heart rate variability(HRV)decreased significantly with the increase of TSH level in subclinical hypothyroidism patients,which indicated that the balance of autonomic nerve on cardiac regulation was weakened in patients with subclinical hypothyroidism,mainly manifested as increased sympathetic tension and decreased vagal tension.

关 键 词：亚临床甲减 促甲状腺激素 心率变异性 心律失常 

分 类 号：R581[医药卫生—内分泌]