累及右冠状动脉的冠心病患者心率变异性研究  

Study on heart rate variability in CAD patients with involved right coronary artery

作　　者：杜金凤 赵刚 DU Jinfeng;ZHAO Gang(Chongqing Medical University,Chongqing 401331,China;Department of Cardiology,Affiliated University Town Hospital,Chongqing Medical University,Chongqing 401331,China)

机构地区：[1]重庆医科大学,重庆401331 [2]重庆医科大学附属大学城医院心血管内科,重庆401331

出　　处：《现代医药卫生》2021年第12期2007-2011,共5页Journal of Modern Medicine & Health

摘　　要：目的通过心率变异性评价冠心病单支血管病变患者自主神经功能,并探讨其与右冠状动脉病变(RCA)的关系。方法选取2016年1月至2020年4月重庆医科大学附属大学城医院心内科行冠状动脉造影患者186例,所有患者均接受24 h动态心电图检查。根据冠状动脉造影检查结果将单支血管病变患者128例作为观察组[进一步分为RCA组(44例)、前降支病变组(54例)和回旋支病变组(30例)],冠状动脉造影正常患者58例作为对照组。各组患者均接受24 h动态心电图检查,分析心率变异性时域指标[正常R-R间期的标准差(SDNN)、5 min R-R间期的标准差(SDANN)、SDNN指数(SDNNidx)、相邻R-R间期之差的均方根(RMSSD)、相邻R-R间期相差大于或等于50 ms占总窦性心搏的百分数(pNN50)]和频域指标[极低频(VLF)、低频(LF)、高频、LF/高频值]的差异。结果观察组患者SDNN、SDANN、SDNNidx、pNN50、RMSSD、VLF、LF均明显低于对照组,差异均有统计学意义(P<0.05)。RCA组患者SDNN、SDNNidx较前降支病变组降低,VLF较回旋支病变组降低,差异均有统计学意义(P<0.05)。结论冠心病患者存在自主神经功能障碍,心率变异性降低与RCA密切相关,通过心率变异性分析可能对RCA具有一定的预示作用。Objective To evaluate the autonomic nerve function in the patients with coronary artery disease(CAD)single-vessel lesion through heart rate variability,and to explore its relationship with right coronary artery(RCA)lesion.Methods A total of 128 patients with coronary arterial angiography(CAG)in the cardiology department of the Affiliated University Town Hospital of Chongqing Medical University from January 2016 to April 2020 were selected and conducted the 24 h dynamic electrocardiogram examination.According to the CAG results,128 cases of single vessel lesion(LAD)served as the observation group[further dividing into the right coronary artery disease(RCA)group(44 cases),anterior descending branch vessel lesion(LCX)group(54 cases)and circumflex branch vessel lesion group(30 cases)],and 58 cases of normal CAG served as the control group.Each group received the 24 h dynamic electrocardiogram examination.The differences in the time domain indicators of heart rate variability(SDNN,SDANN,SDNNidx,RMSSD,pNN50)and frequency domain indicators(VLF,LF,HF,LF/HF ratio)were compared.Results The values of SDNN,SDANN,SDNNidx,RMSSD,VLF and LF in the observation group were significantly lower than those in the control group,and the differences were statistically significant(P<0.05).The values of SDNN and SDNNidx of the RCA group were lower than those of the LAD group,the value of VLF was lower than that of the LCX group,the differences were statistically significant(P<0.05).Conclusion The patients with CAD have the autonomic nerve dysfunction,and the reduction of heart rate variability is closely related to RCA.The analysis of heart rate variability may have a certain predictive effect on RCA.

关 键 词：冠心病 右冠状动脉 窦房结 心率变异性 自主神经功能 

分 类 号：R541.4[医药卫生—心血管疾病] R540.41[医药卫生—内科学]