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目的:采用窦性心率震荡(heart rate turbulence,HRT)指标的震荡初始(turbulence onset,TO)、震荡斜率(turbulence slope,TS)评价冠状动脉心脏病患者的心脏自主神经的功能性重构。方法:选取89例厦门大学附属第一医院近两年来曾行动态心电图检查的可计算HRT相关指标的心内科住院患者,依照疾病谱分为陈旧性心肌梗死患者28例(A组)、稳定性心绞痛患者31例(B组),并设置行经皮冠状动脉介入治疗+支架植入术治疗至少半年后的心绞痛患者30例作为对照组1(C组)。另取具有相同的其他主要疾病背景的同年龄段人群122例作为对照组2(D组),对上述四组的TO和TS进行比较分析。结果:A,B组与C,D组的TS指标差异有统计学意义(P<0.05),TS指标异常程度与自主神经功能重构呈正相关(r=0.351,P<0.05)。结论:HRT的TS指标对心脏自主神经功能性重构具有一定的定量评价价值。
OBJECTIVE: To evaluate the functional remodeling of cardiac autonomic nervous system in patients with coronary heart disease using the heart rate turbulence (HRT) indicators of turbulence onset (TO) and turbulence slope (TS). Methods: Eighty-nine inpatients with cardiology department who had computed HRT related indexes of the first affiliated hospital of Xiamen University in the past two years were divided into 28 patients (group A) with stable myocardial infarction Thirty-one patients with angina pectoris (group B) and 30 patients with angina pectoris who underwent percutaneous coronary intervention and stent implantation for at least six months as control group 1 (group C). Another 122 patients of the same age group with the same background of other major diseases as control group 2 (group D), TO and TS of the above four groups were compared and analyzed. Results: There was a significant difference in TS index between groups A, B and C, D (P <0.05). The abnormality of TS was positively correlated with autonomic nervous system remodeling (r = 0.351, P <0.05). Conclusion: The TS of HRT has a certain quantitative value for the functional remodeling of cardiac autonomic nervous system.