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目的探讨扩张性心肌病(DCM)患儿心率变异性(HRV)变化的预后意义。方法收集42例扩张性心肌病患儿,分成A组心功能Ⅰ～Ⅱ级(NYHA分级,n=20)和B组心功能Ⅲ～Ⅳ级(n=22),以及健康儿童对照组(n=20);采用Mars3000动态心电图仪常规记录24h动态心电图,分析HRV时域参数(SDNN、SDANN、PNN50和rMSSD)和频域参数(TF、VLF、LF、HF、LF/HF)。结果(1)DCM患儿(A组与B组)与对照组比较,各参数差异均有统计学意义(P<0.01);(2)DCM患儿共死亡16例,存活26例,死亡组与存活组各参数比较,t检验有统计学意义。结论HRV可作为评估DCM患儿病情程度的指标,并可作为预后的预测因子。
Objective To investigate the prognostic significance of heart rate variability (HRV) in children with dilated cardiomyopathy (DCM). Methods Forty-two children with dilated cardiomyopathy were enrolled and divided into three groups: group Ⅰ ~ Ⅱ (NYHA class, n = 20) and group Ⅲ ~ Ⅳ (n = 22) = 20). HRV time-domain parameters (SDNN, SDANN, PNN50 and rMSSD) and frequency domain parameters (TF, VLF, LF, HF and LF / HF) were recorded by using the Holter3000 dynamic electrocardiograph. Results (1) DCM children (group A and group B) compared with the control group, the differences were statistically significant (P <0.01); (2) There were 16 deaths, 26 survivals, Compared with the survival group parameters, t test was statistically significant. Conclusion HRV can be used as an index to assess the severity of DCM children and can be used as a predictor of prognosis.