中国冶金工业医学杂志

心率变异性评价持续性房颤自主神经功能的价值

作者：汪剑锋罗博哲李智等

关键词：R 54文献标志码：A文章编号：1005-5495(2012)06-0624-03

分类号：关键词：心房颤动；心率变异性；自主神经功能

出版年,卷(期):页码：2012,29(6):624-626

摘要：

目的探讨持续性心房颤动（PAF）时心率变异性（HRV）评价自主神经功能（AUF）的价值。方法选取符合ACC/AHA（2006）中PAF诊断标准的PAF患者110例，患者在行12导联同步动态心电图检查当日晨6时左右采肘静脉血2管各4 ml，采用ELISA法分别检测血清乙酰胆碱酯酶（AChE）和血浆去甲肾上腺素（NE）水平；检测采血前5 min的HRV指标和平均心室率，并计算R\|R间期标准差（SDNN）、相邻R\|R间期差的均方根(rMSSD)、低频（LF）、高频（HF）及LF/HF比值，采用Pearson相关分析法分析SDNN、rMSSD、LF、HF、LF/HF比值和平均心室率与血浆NE和血清AchE水平间的相关性。结果血浆NE水平与SDNN、rMSSD、LF呈负相关（r值分别为-0236、-0224、-0191，P均＜005），与平均心室率呈正相关（r=0408,P＜001），而与HF及LF/HF无显著相关性（P＞005）；血清ACHE水平与SDNN、rMSSD、LF、HF、LF/HF及平均心室率均无显著相关性（P均＞005）。结论（1）PAF时HRV分析对AUF无直接评价作用；（2）PAF患者心室率部分受AUF调控。

Abstract: ObjectiveTo identify whether HRV can be used to evaluate autonomic function in patients with PAFMethodsOne hundred and ten patients with PAF were enrolledThe diagnosis of PAF was conformed to ACC/AHA 2006 guidelines for the management of patients with atrial fibrillation executive summaryThe paroxysmal AF was excluedVenous blood sample was collected at 6am during 12\|lead ambulatory ECG monitoring from every patientBoth plasma NE and serum ACHE were examinedThe parameters of 5 minutes HRV before time of collecting blood which include standard deviation of the R\|R intervals(SDNN),Root\|mean\|square of the successive differences of normal R\|R intervals(rMSSD),low frequency(LF),high frequency(HF)and LF/HF were calculated and analyzed by 12\|lead ambulatory ECGThen Pearson correlation analysis was done between the parameters of HRV and the average ventricular rate and plasma NE and serum ACHEResultsPlasma NE and SDNN,RMSSD and LF were negatively correlated(r values were -0236,-0224,-0191,P values were 0013,0019,0046)Correlationship was not found between plasma NE and HF and LF/HF(P＞005)Plasma NE and the average ventricular rate was positively correlated (r=0408,P=0000)There is no correlationship between serum ACHE and SDNN,rMSSD,LF,HF,LF/HF and average ventricular rate(P＞005)ConclusionThe ventricular rate in patients with PAF is affected partly by autonomic functionThis functional change can not be reflected directly by HRV

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参考文献：

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