非心肌梗死冠心病患者心率变异性分析

目的探讨非心肌梗死冠心病（NⅧcHD）患者在合并心力衰竭和／或合并非恶性室性心律失常情况下心率变异性的变化情况。方法39例NMICHD患者根据有无合并室性心律失常和有无合并心力衰竭分A、B、C、D4组，与30例健康志愿者的心率变异性进行分析对比。结果A、B、C组的SDNN较健康对照组降低（P〈0．05），D组的SDNN、SDNNindex、rMSSD、PNN50与健康对照组比较差异无显著性（P〉0．05）；A或B组较C或D组的SDNN、SDNNindex、rMSSI）、PNN50皆豆著降低（P〈0．05）；A与B组之间，C与D组之间的SDNNindex、rMSSD、PNN50差异无显著性（P〉0．05）。结论在观察的心率变异性时域指标中，SDNN是反映非心肌梗死冠心病患者自主神经受损最敏感的指标。非心肌梗死冠心病患者合并心力衰竭较合并非恶性室性心律失常更易引起心率变异性下降，可能具有更高的危险性。

Analysis of heart rate variability in patients with non- myocardial infarction coronary heat disease

Objective To investigate the heart rate variability （HRV） in patients with non- myocardial infarction coronary heat disease （NMICHD） together with chronic heart failure and/or nonmalignant ventricular arrhythmia. Methods Thirty - nine NMICHD patients were divided into A, B, C and D group according to whether there was chronic heart failure and/or ventricular arrhythmia, and compared with 30 healthy subjects （control group）. All these cases were monitored with 24 h ambulatory electrocardiogram to analyze the HRV differences among these groups. Results SDNN in A or B or C group was lower than that in control group （ P 〈 0.05 ）. There were no significant differences of SDNN, SDNNindex, rMSSD, PNN50 between D group and control group （ P 〉 0.05 ）. All the time domain parameters in A or B group were significantly lower than that in C or D group （ P 〈 0.05 ）. There were no significant differences of SDNN index, rMSSD, PNN50 between A and B group or between C and D group （ P 〉 0.05）. Conclusion Of the time domain parameters of HRV. SDNN is the most sensitive one reflecting the imbalance of the autonomic nervous system in patients of NMICHD. HRV in patients of NMICHD with chronic heart failure are significantly lower than that with nonmalignant ventricular arrhythmia. It indicates that patients of NMICHD with chronic heart failure have higher risk.