摘要
提要为探讨心力衰竭（ＣＨＦ）患者心率变异性（ＨＲＶ）的变化规律及其病理生理机制，本文采用时域及频域两种分析方法，对９２例ＣＨＦ患者５１例健康人进行了ＨＲＶ对比分析，并对部分患者进行血浆儿茶酚胺（ＮＥ、Ｅ）浓度测定及ＨＲＶ随访。发现：健康人及ＣＨＦ患者的ＨＲＶ有明显的昼夜变化规律，夜间ＨＲＶ＞白天；ＣＨＦ患者的ＨＲＶ明显低于健康组，且与病情及心功能明显相关；近期死亡者ＨＲＶ降低更加明显；血浆ＮＥ及Ｎ浓度明显高于健康组。因此，心衰患者ＨＲＶ降低提示：心衰病人交感神经及迷走神经的调节功能明显受损；心衰患者ＨＲＶ的数量变化，反应患者病情变化；高的血浆儿茶酚胺浓度间接说明了ＣＨＦ心脏自主神经功能受损是神经激素系统激活的结果。
To study the variance rules and the mechanism of pathophysiology ofheart rate variability (HRV) in patients with congestive heart failure (CHF), in thepresent study HRV was assessed in 92 patients with CHF and 51 normal subjects as con-trols. HRV was analysed with a Holter analysis system, in the time domain and fre-quency domain. The concentration of catecholamines in plasma and HRV have been fol-lowed up in some patients. It was found that: (1) HRV of nomal subjects and CHFgroup had a definite circadian variation. The HRV was higher in night than day time.(2) HRV was significantly lower in the CHF group than in controls and definite relatedto NYHAFC in the CHF group. (3) HRV of the deaths in the near future of CHF groupdecreased more significantly. (4)The concentrations of NE and E were greatly higher inCHF group than control group. Therefore, HRV of patients with CHF is significantlydiminished comparing with normal subjects. These reasults suggest that both vagal toneand sympathetic activition of heart are impaired. The changes of HRV in patients withCHF correspond to the severity of the clinical condition. High concentration of adrenlinecan indirectly explain that the impairment of autonomic nervous activity in heart is theresult of the sustained activation of endogenous neurohoronal systems.
出处
《临床心电学杂志》
1996年第1期4-8,共5页
Journal of Clinical Electrocardiology
关键词
心力衰竭
心率变异性
时域分析
频域分析
congestive heart failure
heart rate variability
time domain anly-sis
frequency domain analysis
catecholamine concentration
