儿童扩张型心肌病心率变异性分析

摘要

目的 探讨儿童扩张型心肌病(DCM)心率变异性(HRV)特点.方法 对36例DCM儿童(DCM组)和54例健康儿童(对照组)长程心率变异指标进行分析.结果 DCM组的时域指标,包括全部正常心动周期(NN间期)的标准差(SDNN)、全程每天5分NN间期平均值的标准差(SDANN)、全程相邻NN间期之差的均方根值(rMSSD)、相邻NN间期之差＞ 50 ms的心搏数占心搏总数的百分比(PNN50)明显降低,与正常对照组比较有统计学意义(P ＜ 0.05);DCM组的频域指标,包括极低频段功率(VLF)、低频段功率(LF)、高频段功率(HF)明显下降,与正常对照组比较差异有统计学意义(P ＜ 0.05);不同心功能的DCM组及2例DCM死亡病例随着心功能的恶化,HRV各指标均呈进行性下降.结论 DCM患儿的HRV明显降低,显示其存在明显的自主神经功能受损和失衡,HRV对预测DCM患儿疾病的病情发展和预后有一定实用价值.%Objective To explore the characteristics of heart rate variability (HRV) in children with dilated cardiomyopathy (DCM). Methods Analysis of HRV time and frequency domain over 24 hours were performed in 36 children with DCM and 54 healthy children. Results Compared with healthy children, time domain (SDNN,SDANN, rMSSD, PNN50) measures of HRV were significantly decreased in children with DCM (all P ＜ 0.05);frequency domain (VLF, LF, HF) measures of HRV were significantly decreased (all P ＜ 0.05) in children with DCM.HRV from two cases of death and two DCM groups with different heart function were retrospectively analyzed and it showed that HRV decreased progressively with the deterioration of heart failure. Conclusions HRV is reduced in children with DCM. HRV indices are sensitive markers of the clinical state and prognosis in children with DCM.