老年人心率变异性减低在预测心血管事件中的价值  

The value of reduced heart rate variability in predicting the cardiovascular events in the elderly

作　　者：刘德平[1] 曾学寨[1] 董榕[1] 潘春宇[1] 巨小湧[1] 杨春英[1] 郭正红[1] 乔巍巍[1] 吴军[1] 窦岩[1] 郭继鸿[2] 

机构地区：[1]卫生部北京医院心内科,100730100044 [2]北京大学人民医院心内科

出　　处：《中华老年医学杂志》2003年第2期80-82,共3页Chinese Journal of Geriatrics

摘　　要：目的　评价老年人心率变异性 (HRV)减低在预测心血管事件中的价值。　方法　对我院 192例干部查体者进行了 2 4h动态心电图HRV检查者进行随访。HRV分析包括正常R R间期的标准差 (SDNN) ,5min平均R R间期的标准差 (SDANN )等。对每例查体者进行随访 (2 1 2±7 3 )个月 (10d～ 3 2个月 ) ,确定有无心血管事件发生。计算HRV指标在预测心血管事件中的OR和95 %可信限 (95 %CI)。　结果　有 2 4例查体者发生心血管事件。HRV时域指标SDNN <10 0ms和SDANN <10 0ms发生心血管事件的OR和 95 %CI分别为 6 0 5和 1 98～ 18 47及 5 0 0和 1 43～17 5 4。对性别及年龄进行校正后 ,SDNN <10 0ms的OR和 95 %CI为 3 13和 1 16～ 8 47。进一步对影响HRV的临床疾病 ,即糖尿病、高血压、冠心病、陈旧性心肌梗死进行校正后 ,SDNN <10 0ms的OR和 95 %CI为 9 17和 1 61～ 5 2 63。　结论　 2 4hHRV的SDNN是一项除性别、年龄、糖尿病、高血压、冠心病。Objective To evaluate the impact of reduced heart rate variability (HRV) on the risk of cardiac events in the elderly. Methods A total of 192 elderly subjects enrolled for routine annual physical examination were examined with 24 hour dynamic electrocardiography and their HRV were analysed. HRV measures included standard deviation of normal R R intervals(SDNN), 5 minute average normal R R intervals (SDANN). Each subject was followed up to identify the occurence of cardiac events. The odds ratio ( OR ) and its 95% confidence interval(95% CI ) were calculated for evaluating the association between HRV measures and the incidence of new cardiac events. Results Twenty four subjects developed new cardiac events during the follow up period(21 2±7 3 months). SDNN<100 ms and SDANN<100 ms of HRV parameters were significantly associated with the risks of the cardiac event( OR 6 05, 95% CI 1 98 18 47 and OR 5 00, 95% CI 1 43 17 54, respectively). After adjustment for sex and age, and additionally for diabetes, hypertension, coronary artery disease and old myocardial infarction, the OR of SDNN<100 ms was 9 17 (1 61 52 63), still showing significant association of SDNN with new cardiac event Conclusions 24 h HRV SDNN offers prognostic information for cardiovascular diseases besides the other risk factors such as sex, age, diabetes, hypertension, coronary artery disease and old myocardial infarction.

关 键 词：老年 心电图 心率 预后 

分 类 号：R54[医药卫生—心血管疾病]