论文部分内容阅读
目的研究重度充血性心力衰竭患者血流动力学的昼夜节律改变。方法选择2005年12月至2006年6月在南京中医药大学无锡附属医院心内科住院的重度充血性心力衰竭患者120例为心衰组,同期门诊体检的无心血管疾病者20名为对照组,采用生物阻抗法每小时1次动态监测心率(HR)和每搏输出量(SV)。结果心衰组与对照组HR、SV均存在昼夜节律,但分布规律存在差异,心衰组HR明显快于对照组(P<0.5),而SV明显低于对照组(P<0.05);对照组HR与SV呈正相关(P<0.01),而心衰组HR与SV总体上也呈正相关(P<0.01),但在凌晨1:00～4:00之间,两组HR与SV分布曲线明显不同,心衰组HR与SV分布曲线出现分离现象,HR下降而SV上升,呈负相关(P<0.01),而同时段的对照组HR与SV则仍呈正相关(P<0.01)。结论重度充血性心力衰竭患者HR和SV分布的昼夜节律受损,在凌晨1:00～4:00之间,HR与SV分布趋势存在分离现象。
Objective To study the hemodynamic changes of circadian rhythm in patients with severe congestive heart failure. Methods 120 cases of severe congestive heart failure hospitalized in Department of Cardiology, Wuxi Affiliated Hospital of Nanjing University of Traditional Chinese Medicine from December 2005 to June 2006 were selected as the heart failure group. Twenty patients without cardiovascular diseases during the same period were selected as the control group, The heart rate (HR) and stroke volume (SV) were dynamically monitored by bioimpedance method once an hour. Results HR and SV of heart failure group and control group both had circadian rhythm, but the distribution was different. The HR of heart failure group was significantly faster than that of control group (P <0.5), and SV was significantly lower than that of control group (P <0.05) There was a positive correlation between HR and SV in group (P <0.01), but HR and SV in heart failure group were also positively correlated (P <0.01), but between 1:00 and 4:00 in the morning, HR and SV distribution curve Significantly different, HR and SV distribution curve of heart failure separation phenomenon, HR decreased and SV increased, was negatively correlated (P <0.01), while the same period the control group HR and SV were still positively correlated (P <0.01). Conclusion The circadian rhythm of HR and SV distribution in patients with severe congestive heart failure is impaired. From 1:00 to 4:00 in the morning, HR and SV distribution trends are separated.