老年住院患者心率变异性和24 h平均心率的相关性分析

老年住院患者心率变异性和24 h平均心率的相关性分析
王雪玲;李泽华;段永利
【期刊名称】《中国循证心血管医学杂志》
【年(卷),期】2017(009)001
【摘要】目的：分析老年住院患者24 h平均心率与时域指标及频域指标的相关性。

方法入选2014年7月~2016年2月于北京市中西医结合医院住院并行动态心电
图检查的老年患者187例，回顾性分析动态心电图资料，根据正常R-R间期标准
差（SDNN），将研究对象分为心率变异性正常组（A组）91例、中度降低组（B 组）66例、重度降低组（C组）30例。

频域结果分为下降、正常、升高三个级别，对比分析组间的24 h平均心率、时域和频域参数。

结果 SDNN、每5 min R-R
间期均值标准差（SDANN）、每5 min正常R-R间期均值标准差（SDNN Index）、相邻正常R-R间期差值均方根值（RMSSD）、相邻正常R-R间期＞50 ms计数占总R-R间期数的百分比（PNN50）、白天SDNN、夜间SDNN、总的频域值（TP）在A、B、C三组间呈降低趋势（组间比较，P均＜0.01）。

24 h平均心率在A、B、C三组间呈升高趋势（组间比较，P均＜0.01）。

A组低频成分（LF）正常比率明显高于B、C组，差异有统计学意义（P＜0.01）；B、C组中
LF下降患者所占比率最高。

A组高频成分（HF）升高患者所占比率最高，B、C
组HF下降患者所占比率最高。

HF下降比率，三组间两两比较，C组高于B组高于A组，差异均有统计学意义。

SDNN与24 h平均心率呈负相关，γs=-0.42（P ＜0.01）。

SDNN与TP呈正相关，γs =0.56（P＜0.01）。

结论老年住院患者SDNN与24 h平均心率呈负相关，与TP呈正相关。

%Objective To explore
the correlations of the time-domain indexes with the frequency-domain
indexes and the average heart rate within 24 hours in elderly inpatients.Methods A total of 187 elderly patients (n=187) admitted from Jul. 2014 to Feb. 2016 in Beijing Hospital of Integrated Traditional Chinese and Western Medicine were chosen. The ambulatory electrocardiography data was retrospectively analyzed. According to Standard Deviation of Normal to Normal (SDNN), all subjects were divided into group A (n=91) with normal Heart Rate Variability (HRV), group B (n=66) with moderately decreased HRV, and group C (n=30) with severely decreased HRV. The frequency-domain indexes were divided into three levels: declined, normal, and elevated. The time-domain indexes, the frequency-domain indexes and the average heart rate within 24 hours were analyzed among the three groups.Results As SDNN decreased, Standard Deviation of Sequential Five-Minute R-R Interval Means (SDANN), SDNN Index, Root Mean Square of the Successive Differences (RMSSD), PNN50 (a measure of the number of adjacent NN intervals which differ by more than 50 ms), SDNN in the daytime, SDNN in the night and TP gradually declined from group A to group C (P<0.01). The average heart rate within 24 hours gradually increased from group A to group C (P<0.01). In group A, normal low frequency (LF) accounted for the highest proportion (P<0.01, compared with group B and C), while declined LF accounted for the highest proportion in both group B and group C (P>0.05). Increased high frequency (HF) accounts for the highest proportion in group A, declined HF accounted for half in group B, and in group C declined HF accounted for the highest proportion. The distinctions of HF among the three groups
were significant respectively (P<0.01). SDNN was negatively correlated with the average heart rate within 24 hours, γs=- 0.42 (P<0.01). SDNN was positivel y correlated with total power (TP), γs=0.56. (P<0.01).Conclusion SDNN was negatively correlated with the average heart rate within 24 hours and positively correlated with TP in elderly inpatients.
【总页数】3页(P50-52)
【作者】王雪玲;李泽华;段永利
【作者单位】100039 北京，北京中医药大学附属北京市中西医结合医院心血管内科;100039 北京，北京中医药大学附属北京市中西医结合医院心血管内科;100039 北京，北京中医药大学附属北京市中西医结合医院心血管内科
【正文语种】中文
【中图分类】R540.41
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