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目的 观察心力衰竭患者窦性心率震荡 (HRT)现象的特征并探讨其临床意义。方法 2 0 0 4 - 0 1～ 0 4哈尔滨医科大学第一临床医学院门诊 30例心衰患者及 30名健康对照者均接受 2 4hHolter检查 ,分别计算HRT的初始值 (TO)、HRT的斜率 (TS) ,并进行TO、TS与年龄、左室射血分数 (LVEF)、左室舒张末期内径 (LVED)、室早数目、室早前心率、联律间期、代偿间期的相关分析及不同起源室早TO、TS的组间比较。结果 心衰者与健康者HRT间存在明显差别 :心衰者TO明显高于对照者 (0 5 7± 4 71%与 - 1 5 6± 2 6 0 % ,P <0 0 2 5 ) ;心衰者TS明显低于对照者 (3 17± 2 0 3%与 9 6 4± 6 4 7,P <0 0 0 1)。TO、TS与年龄、LVEF、LVED、室早数目相关 ,与室早前心率、联律间期、代偿间期不相关 ,起源不同室早的TO、TS间无明显差异。结论 慢性心衰患者中窦性心率震荡现象明显减弱 ,由于TO、TS与LVEF、LVED相关 ,可凭借TO、TS对心衰患者进行危险分层 ,但它对预后的预测价值有待于大样本长期随访来证实。
Objective To observe the characteristics of sinus heart rate turbulence (HRT) in patients with heart failure and to explore its clinical significance. Methods 30 patients with heart failure and 30 healthy controls in First Affiliated Hospital of Harbin Medical University underwent 24 hHolter examination. The initial values of HRT (TO), the slope of HRT (TS), and TO, TS and age, left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVED), ventricular number of early ventricular heart rate, Analysis and different origins of room early TO, TS comparison between groups. Results There was a significant difference in HRT between heart failure and healthy people: the TO of heart failure was significantly higher than that of controls (0 57 ± 4 71% vs - 156 ± 2 60%, P 0 025); heart The decline of TS was significantly lower than the control (3 17 ± 2 0 3% and 9 6 4 ± 6 4 7, P <0 0 0 1). There was no significant difference between TO and TS in age, LVEF, LVED and ventricular premature ventricular mass. There was no significant difference between TO and TS in age, ventricular tachycardia and compensatory interval. Conclusion The sinus rhythm of heart failure in patients with chronic heart failure is obviously weakened. Due to the correlation between TO, TS and LVEF and LVED, risk stratification can be performed on TO and TS patients. However, the prognostic value of TO, TS in long-term Follow-up to confirm.