摘要
目的 探讨慢性心力衰竭（CHF）患者窦性心率震荡（HBT）的临床意义.方法 30例CHF患者（CHF组）及28例非器质性心脏病患者（对照组）行24 h动态心电图检查.根据NYHA心功能分级,将CHF组分为轻度CHF组（Ⅰ～Ⅱ级）16例及重度CHF组（Ⅲ～Ⅳ级）14例;CHF组中缺血性心脏病18例及非缺血性心脏病12例.分析比较各组HRT的初始值（TO）及震荡斜率（TS）两项指标.结果 CHF组TO值[（0.43±0.83）%]较对照组[（-1.49±1.00）%]明显增高（P＜0.05）,CHF组TS值[（2.67±0.66）ms/RRI]较对照组[（8.52±2.09）ms/RRI]明显降低（P＜0.05）.重度CHF组TO值[（0.79±0.67）%]较轻度CHF组[（0.12±0.86）%]明显增高（P=0.026）,重度CHF组TS值[（2.88±0.79）ms/RRI]较轻度CHF组[（2.40±0.35）ms/RRI]明显增高（P=0.045）.缺血性心脏病与非缺血性心脏病患者TO及TS值比较差异无统计学意义（P＞0.05）.CHF组中TO及TS值同时异常（TO≥0,TS≤2.5 ms/RRI）占53.3%（16/30）,而TO或TS值仅1项异常占40.0%（12/30）,CHF组HRT检测异常率为93.3%（28/30）.结论 CHF患者HRT现象明显减弱,HRT可作为CHF严重程度的有效观测指标,对CHF患者预后的预测起指导作用.
Objective To explore the clinical significance of heart rate turbulence （HRT） in patients with chronic heart failure（CHF）.Methods Thirty CHF patients（CHF group） and 28 non-organic heart disease persons （control group） were examined by 24 hours dynamic electrocardiogram （DCG）.According to the NYHA grading of the cardiac function,CHF group were divided into low-degree heart failure （LdHF） sub-group （NYHA Ⅰ -Ⅱ,16 cases） and high-degree heart failure （HdHF） sub-group （NYHA Ⅲ-Ⅳ,14 cases）.In CHF group,ischemic heart disease （IHD） patients were 18 cases and non-ischemic heart disease （NIHD） patients were 12 cases.Two indexes of HRT including turbulence onset （TO） and turbulence slope （TS） were measured and analyzed.Results The TO value in CHF group [（0.43 ±0.83）%] was significantly higher than that in control group [（ - 1.49 ± 1.00）%] （P 〈0.05）,and the TS value in CHF group[（ 2.67 ± 0.66） ms/RRI] was significantly lower than that in control group [（ 8.52 ± 2.09）ms/RRI] （P 〈0.05）.The TO value in the HdHF sub-group [（0.79 ± 0.67）%] was significantly higher than that in LdHF sub-group[（0.12 ± 0.86）%] （P = 0.026）,and the TS value in the HdHF sub-group [（2.88 ±0.79） ms/RRI] was significantly higher than that in LdHF sub-group [（2.40 ± 0.35） ms/RRI] （P= 0.045）.The TO and TS values had no significant difference between the IHD and the NIHD patients （P〉0.05）.In CHF group,53.3%（16/30） patients＇ TO and TS values were both abnormal （TO ≥ 0,TS ≤ 2.5 ms/RRI）,and 40.0% （12/30） patients had only TO or TS value abnormal,93.3% （28/30） patients had abnormal HRT.Conclusion The phenomenon of HRT in the patients with CHF obviously decrease,and the HRT can be used to evaluate the severity of heart failure and predict the prognosis of the heart failure.
出处
《中国医师进修杂志》
2010年第28期23-25,共3页
Chinese Journal of Postgraduates of Medicine
关键词
心力衰竭
慢性
预后
心率震荡
Heart failure,chronic
Prognosis
Heart rate turbulence
