摘要
目的 探讨心脏自主神经功能对特发性室性早搏（IVPB）的影响。方法 选择2012年12月~2013年12月于武汉大学人民医院就诊的患者168例,将其分为正常对照组（n=25）和IVPB组（n=143）。采用24 h动态心电图分析患者室性心律失常发生情况,并计算总功率（TP）、高频（HF）、低频（LF）、平衡比（LF/HF）等心率变异分析（HRV）指标及震荡初始（TO）、震荡斜率（TS）等心率震荡（HRT）指标。比较两组患者自主神经功能差异情况,并分析自主神经功能指标与室早频度、发作形式及Lown分级的关系。结果 IVPB组的HRV及HRT各项指标与正常对照组比较,差异均无统计学意义（P〉0.05）;但在IVPB组中,随着室早频度的增加,TS值及TO绝对值均有降低趋势。与不伴成对室早的患者比较,合并成对室早的患者TP、LF、HF、TO、TS均显著下降（均P〈0.05）。随着室早Lown分级增高,TP、LF、HF、TS值与TO绝对值均有降低的趋势。与Lown 2级比较,Lown 4a、4b级室早的TP、LF、HF、TO及TS均显著降低（P〈0.05或P〈0.01）。结论 心脏自主神经功能的减退与特发性室性心律失常的恶性程度相关,迷走神经张力的下降可能增加特发性室性心律失常的恶性程度。
Objective To investigate the influences of cardiac autonomic function on idiopathic ventricular premature beat（IVPB）. Methods 143 cases of patients from December 2012 to December 2013 in Renmin Hospital of Wuhan University were selected, and they were divided into 143 patients with IVPB（IVPB group） and 25 controls（control group）. 24 h holter ECG were used to analyze the occurrences of ventricular arrhythmias, the HRV（TP, HF, LF, LF/HF） and HRT（TO, TS） were calculated. Autonomic nervous function of two groups were compared and the relationship between nervous function parameters and frequency, onset form, Lown grading of IVPB were analyzed. Results There was no difference in indices of HRV or HRT between two groups were observed（P〈0.05）. But in IVPB group, both TS and TO were decreased as the premature ventricular frequency increased. Patients with couplets PVC had significantly lowered TP, LF, HF, TO and TS compared with those without couplets（all P〈0.05）, and these indices also showed a decreasing trend in patients with ventricular tachycardia（VT） compared with those without VT. In addition,TP, LF, HF, TO and TS showed a decreasing trend as the Lown classification level increases. TP, LF, HF, TO and TS of patients with high Lown classifications（level 4a, 4b） were lower than those of the patients in level 2（P〈0.05 or P〈0.01）. Conclusion Impaired cardiac autonomic function might be related to the malignancy of idiopathic ventricular arrhythmias and vagal wihtdrawl may increase the malignancy.
出处
《中国医药导报》
CAS
2014年第36期30-34,共5页
China Medical Herald
基金
国家自然科学基金项目(编号81270339
81370281)
湖北省武汉市科技攻关项目(编号2013060602010271)
武汉大学青年教师自主科研项目(编号2042012121087)
作者简介
【作者简介】王松云（1990-），硕士，主要从事心律失常研究。
【通讯作者】江洪（1958-），男，教授，博士生导师，主要从事心律失常机制及介入心脏病学研究。
