非协调性与协调性左束支阻滞患者的心率变异性对比分析  

Comparative analysis of heart rate variability in patients with discordant or concordant left bundle branch block

作　　者：李煜[1] 林苏华[1] 杨利娟 LI Yu;LIN Suhua;YANG Lijuan(Department of Cardiac Function,Zhongshan Hospital of Xiamen Uni-versity,Xiamen Fujian 361004,China)

机构地区：[1]厦门大学附属中山医院心功能科,福建厦门361004

出　　处：《实用心电学杂志》2022年第5期346-348,354,共4页Journal of Practical Electrocardiology

摘　　要：目的分析非协调性与协调性左束支阻滞(left bundle branch block,LBBB)患者的心脏自主神经功能变化情况。方法选取112例心电图表现为LBBB的患者进行动态心电图检查,其中非协调性LBBB患者80例(非协调组),协调性LBBB患者32例(协调组)。分析各组心率变异性(heart rate variability,HRV)时域指标SDNN、SDANN、ASDNN,并对比两组患者HRV降低的发生率。结果非协调组的SDNN、SDANN、ASDNN数值较协调组显著降低(P<0.05);协调组有6例(18.75%)HRV降低,非协调组有36例(45.00%)HRV降低,非协调组HRV降低的发生率较协调组显著增高(P<0.05)。结论非协调组较协调组更易出现心脏自主神经调节功能降低,更易出现心电活动不稳定,发生心血管事件的风险也更大。临床医生应更重视对非协调性LBBB患者的及时诊疗与随访,以减少并发症和降低死亡率。Objective To analyze the changes of cardiac autonomic function in patients with discordant or concordant left bundle branch block(LBBB).Methods A total of 112 patients manifested by LBBB in ECG were selected for ambulatory electrocardiography examination.There were 80 patients with discordant LBBB(discordant group)and 32 patients with concordant LBBB(concordant group).We analyzed heart rate variability(HRV)time domain indexes of SDNN,SDANN and ASDNN,and compared the incidence of HRV decrease between the two groups.Results The SDNN,SDANN and ASDNN values of the discordant group are significantly lower than those of the concordant group(P<0.05).In the concordant group,HRV indexes of 6 cases(18.75%)are reduced.In the discordant group,HRV indexes of 36 cases(45.00%)are reduced.The incidence of HRV decrease in the discordant group is significantly higher than that in the concordant group(P<0.05).Conclusion Compared with the concordant group,the patients in the discordant group are more prone to declined cardiac autonomic regulation function and instable electrical activities,which leads to a higher risk of cardiovascular events.Clinicians should pay more attention to making timely diagnosis,treatment and follow-up for patients with discordant LBBB to reduce complications and mortality.

关 键 词：动态心电图 左束支阻滞 心率变异性 心血管事件 

分 类 号：R541.76[医药卫生—心血管疾病]