扩张型心肌病患者心率变异性变化及其与心脏舒缩功能相关性研究  

Changes of heart variability and its relativity with cardiac function in patients with dilated cardiomyopathy

作　　者：周裔忠[1] 祝善俊[1] 于林君[1] 李振魁[1] 王江[1] 

机构地区：[1]第三军医大学新桥医院心内科,重庆市400037

出　　处：《岭南心血管病杂志》2004年第1期17-20,共4页South China Journal of Cardiovascular Diseases

摘　　要：目的　探讨扩张型心肌病患者心率变异性的改变及其与心脏舒缩功能的相关性。方法　选出心功能为Ⅰ～Ⅳ级的 4 0例扩张型心肌病患者 ,并用年龄、性别均与之匹配的 36例健康人作为对照组 ,用Holt对两组对象进行2 4h动态检测 ,从当日 6点至次日 6点 ,并记录心率变异性指标 (SDNN、RMSDD、PNN50 、TP、VLF、LF、HF、LF/HF) ;用彩色多普勒超声心动图检测心肌舒缩功能的指标 (IRT、E/A、FS、EF、LVEDD、LAEDD) ,并分析这两类指标之间的相关性。结果　本研究发现扩张型心肌病患者的心率变异性较对照组明显降低 ,而且心率变异性与其心功能分级有关 ,随着心功能的下降心率变异性呈下降趋势 ,Ⅲ～Ⅳ级DCM患者心率变异性最为明显 ;且LF/HF之值与其心肌收缩、舒张功能指标有较好的相关性。结论　扩张型心肌病患者心率变异性下降 ,自主神经平衡失调 ,主要表现为交感神经的持续激活 ;扩张型心肌病患者的LF/HF可作为反映DCM患者心功能及预后的无创性预测指标。Objectives To explore the changes of heart rate variability (HRV) and its relativity to the cardiac function parameters in patients with dilated cardiomyopathy (DCM). Methods From six o'clock to the next six o'clock, twenty-four-hour HRV parameters including SDNN? RMSDD? PNN 50?TP? VLF? LF? HF? LF/HF, and cardiac function index including FS? EF? LVEDD? LAEDD? IRT? E/A were measured in 40 DCM patients and 36 normal controllers using Holter ECG and Color Doppler Echocardiography respectively; linear regression was used to analyze the relativity between HRV and cardiac function parameters. Results HRV parameters were significantly decreased compared with the control, and were highly related with the state of cardiac function. Following the depravation of cardiac function, HRV was gradually decreased, especially in the patients with cardiac function of Ⅲ～Ⅳ class. The highly relativity was found between the ratio of LF/HF and the cardiac function parameters, but was not found between the HF and later. Conclusions The disequilibrium of Autonomic nerve system with the persistent activation of sympathetic nerve and the decrease of HRV exist in patients with DCM,the test of LF/HF may be helpful in the prognostic value in DCM patients.

关 键 词：扩张型心肌病 心率变异性 心脏舒缩功能 相关性 超声心动图 

分 类 号：R542.2[医药卫生—心血管疾病]