冠状动脉病变程度与窦性心率震荡相关性研究.docVIP

冠状动脉病变程度与窦性心率震荡相关性研究 　　[摘要] 目的：研究冠心病患者冠状动脉病变严重程度与窦性心率震荡（HRT）的相关关系。方法：选择110 例完成冠状动脉造影的患者，根据冠状动脉造影结果进行分组，分为对照组(45)、冠状动脉单支病变组(23例)、双支病变组(27例)和三支病变组(15)例；冠状动脉造影前2周内完成24 h动态心电图检查，计算心率震荡参数：震荡起始（TO）及震荡斜率（TS）值，比较冠心病患者与对照组及冠心病患者各组间的TO、TS值。结果：冠心病患者心率震荡起始TO值增高，与对照组比较，差异有统计学意义(P 　　[关键词] 冠状动脉病变；窦性心率震荡；冠状血管造影；自主神经系统 　　[中图分类号] R543.3[文献标识码]A [文章编号]1673-7210（2008）08（a）-016-02 　　 　　Study on correlations between coronary artery lesion and heart rate turbulence 　　LUO Yan-luan 　　(Department of Electrocardiogram, the Second Affiliated Hospital, Medical College of Shantou University， shantou 515041, China) 　　[Abstract] Objective: To assess the correlation between coronary artery lesion and heart rate turbulence (HRT).Methods: Coronary angiography was completed in patients suspected coronary artery disease. 110 patients were divided to 4 groups: non-coronary heart disease group(45 patients), coronary heart disease group with only one coronary artery involved (coronary heart disease group 1, 23 patients), coronary heart disease group with two coronary artery involved (coronary heart disease group 2, 27 patients), coronary heart disease group with three coronary artery involved(coronary heart disease group 3, 15 patients). Two weeks before coronary angiography, 24 hours dynamic electrocardiogram was used to collect HRT parameter, TO and TS. Results:There was increase in TO, decrease in TS. The greater the range of coronary disease, the more serious the coronary artery lesion. Conclusion:There is correlation between the extent of coronary disease and the parameters. 　　[Key words] Coronary heart disease; Heart rate turbunence; Coronary angiography; Automatic nervous system 　　 　　窦性心率震荡（heart rate turbulence，HRT）具有无创、简单、可靠等优点，用它来检测心脏自主神经调节功能已逐渐展现了其广阔的应用前景。在室性早搏后的心率存在两种不同的变化 一是特征性的双相式涨落。???在室性早搏后，心率先加速，后减速，称之为窦性心率震荡[1]，见于正常人及低危患者。二是HRT减弱或消失。则室性早搏前、后心律RR间期无明显变化，见于器质性心脏病后猝死的高危患者。这种室性早搏后，出现短期心率波动的现象，是自主神经对单发室早后出现动脉血压波动做出的反应，它与压力反射的敏感性密切相关[2，3]。本文主要研究冠心病患者与对照组及冠心病患者各组间HRT的关系。 　　1资料与方法