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目的探讨心律震荡对冠心病患者预后的预测价值。方法选择60例冠心病患者(冠心病组)及30例健康志愿者(对照组),进行24h动态心电图检查,分别测定震荡初始、震荡斜率以及全部正常窦性RR间期的标准差(SDNN)、全程相邻RR间期之差的均方根(RMSSD)、全部RR间期中,相邻的RR间期之差大于50ms的个数占总的RR间期个数的百分比(pNN50)等心率变异性系数,并进行统计分析。结果与对照组相比,冠心病组震荡初始值明显升高,震荡斜率值明显降低,差异有统计学意义(P<0.01);冠心病组的SDNN、RMSSD、pNN50明显低于对照组,差异有统计学意义(P<0.01)。结论冠心病组室性期前收缩后窦性心律震荡减弱,提示患者的自主神经功能明显受损,心律震荡可作为冠心病患者预后的预测指标之一。
Objective To investigate the predictive value of cardiac arrhythmia on the prognosis of patients with coronary heart disease. Methods Sixty patients with coronary heart disease (CHD) and 30 healthy volunteers (control group) were enrolled in this study. 24h dynamic electrocardiogram (ECG) was used to measure the initial shock, the slope of oscillation and the standard deviation of all normal sinus RR intervals (SDNN) , The root mean square (RMSSD) of the difference between adjacent RR intervals, the percentage of the total number of RR intervals (pNN50) among all the RR intervals, the difference between adjacent RR intervals greater than 50 ms, and the like Variability coefficient, and statistical analysis. Results Compared with the control group, the initial value of concussion increased significantly and the concussion slope decreased significantly (P <0.01). The levels of SDNN, RMSSD and pNN50 in CHD group were significantly lower than those in control group There was statistical significance (P <0.01). Conclusions Coronary sinus rhythm is weakened after premature ventricular contractions in CHD group, suggesting that autonomic nerve function is significantly impaired in patients with coronary heart disease. Heart rate turbulence may be one of the predictors of prognosis in CHD patients.