心率变异性与冠心病心电图心肌缺血的改变(1)
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[摘要] 目的:了解缺血时心率变异性(HRV)的改变,探讨冠心病自主神经失衡的状况。方法:前瞻、顺序地观察21例静息心电图呈典型心肌缺血的冠心病患者、19例心电图正常的冠心病患者和22例健康人的HRV时域、频域指标。结果:与对照组比较,静息心电图呈典型心肌缺血的冠心病组HRV降低非常显著(P<0.01)的指标为SDNN[(113±12) ms与(85±23) ms]、SDANN[(100±14) ms与(74±22) ms]、TP[(2 170±794) ms与(1 366±859) ms]、VLP[(1 422±473) ms与(1 924±568) ms];显著降低(P<0.05)的指标为SDNNIndex[(48±11) ms与(39±12) ms]、LF[(441±258) ms与(279±193) ms]、HF[(266±171) ms与(142±157) ms]。与对照组比较,心电图正常的冠心病组LF/HF增大非常显著[(2±1)与(3±2),P<0.01],其余各项指标降低差异无统计学意义(P<0.05)。与心电图正常的冠心病组比较,静息心电图呈典型心肌缺血的冠心病组SDNN、SDANN、LF进一步降低[(107±301) ms与(85±223) ms,(96±29) ms与(74±22) ms,(496±383) ms与(279±193) ms,P<0.05]。结论:冠心病患者HRV多项指标普遍降低而LF/HF增大,表明交感、迷走神经张力不均衡地降低而交感神经相对兴奋。冠心病患者HRV降低可能与其心肌缺血的程度有关。
[关键词] 冠心病;心率变异性;心肌缺血;心电图
[中图分类号] R541.4[文献标识码]A [文章编号]1673-7210(2010)06(a)-020-03
Relationship between change of myocardial ischemia and heart rate variability in patients with coronary artery disease
DUAN Bin
(The Second People's Hospital of Huaihua City, Huaihua 418000, China)
[Abstract] Objective: To understand the relationship between myocardial ischemia and heart rate variability (HRV), and study changes in agronomic nervous function in patients with coronary artery disease. Methods: Investigated HRV in 21 patients with typical myocardial ischemia, 19 patients without typical myocardial ischemia in rest electrocardiogram (ECG), and 22 healthy volunteers. Results: Compared with healthy volunteer group, HRV in diseased group decreased very significantly (P<0.01) with indices of SDNN[(113±12) ms vs (85±23) ms], SDANN[(100±14) ms vs (74±22) ms], TP[(2 170±794) ms vs (1 366±859) ms], VLP[(1 422±473) ms vs (1 924±568) ms]; the following indicators showed significantly decrease (P<0.05): SDNNIndex[(48±11) ms vs (39±12) ms], LF[(441±258) ms vs (279±193) ms], HF[(266±171) ms vs (142±157) ms] in patients with typical myocardial ischemia. Compared with healthy volunteers, LF/HF increased significantly [(2±1) vs (3±2),P<0.01], and other components of HRV were tended to decrease but no significant change in patients without typical myocardial ischemia (P>0 ......
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