摘要
目的：探讨不稳定型心绞痛（unstable angina pectoris,UAP）患者窦性心律震荡（heart rate turbulence,HRT）的变化及临床意义。方法：选择本院2008年2月~2010年2月住院的UAP患者60例,根据冠脉血管病变部位分为单支病变组（n=18）、双支病变组（n=30）及三支病变组（n=12）三个亚组。健康对照组65例。所有患者均接受24 h动态心电图检查,应用美国Del Holter分析系统分别测量窦性心律震荡的参数震荡初始（turbulence onset,TO）及震荡斜率（turbulence slope,TS）。结果：UAP患者TO较正常对照组显著升高[（0.89±1.34）%vs（0.58±1.48）%],TS较正常对照组显著降低[（4.11±2.53）ms/RR vs（7.45±2.21）ms/RR],两参数较正常对照组变化差异均有统计学意义（P〈0.05）。冠脉病变程度越严重,窦性心律震荡减弱越明显,相关性分析表明冠脉病变程度与TO正相关（r=0.463,P〈0.01）,与TS负相关（r=-0.581,P〈0.01）。结论：UAP患者HRT明显减弱。HRT可作为评价UAP患者自主神经功能状态指标和发生心脏事件的独立预测因素,同时可作为判断UAP患者冠脉病变严重程度的可靠参考指标。
Objective：To explore the changes and clinical significance of heart rate turbulence（HRT） in patients with unstable angina pectoris（UAP）.Methods：60 patients with unstable angina pectoris in the heart medicine wards were chosen from Feb 2008 to Feb 2010.Three groups were obtained of mono-vessel group（n=18）,diplo-vessel group（n=30） and tri-vessel group（n=12）,by the difference of the coronary arterial narrow site.65 control subjects without organic heart disease were enrolled.All subjects were performed 24 hours ambulatory electrocardiogram.The 24 hours Holter record of each subject was processed by Del Holter vision HRT analysis software.HRT was stated by two parameters which includes HRT turbulence onset（TO） and HRT turbulence slope（TS）.Results：Compared with the control group,the value of TO was significantly higher in UAP patients [（0.89±1.34）% vs（0.58±1.48）%]（P〈0.05）,while the value of TS was significantly lower in UAP patients[（4.11±2.53）ms/RR vs（7.45±2.21）ms/RR]（P〈0.05）.TO was positively（r=0.463,P〈0.01）,while TS was negatively（r=-0.581,P〈0.01） related to the severity of the coronary artery in UAP patients.Conclusion：The HRT in patients of UAP is lessened,which shows the UAP patients of cardiac autonomic nerve function and the risk of cardiac accident.HRT can be a useful marker to evaluate the severity of the coronary artery in the UAP patients.
出处
《中国医药导报》
CAS
2011年第30期178-179,共2页
China Medical Herald
关键词
不稳定心绞痛
窦性心律震荡
动态心电图
Unstable angina pectoris
Heart rate variability
Ambulatory electrocardiogram
