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目的探讨不同起源特发性室性期前收缩患儿的心率变异性(HRV)与心率减速力(DC)各项指标的关联性。方法回顾性分析155例特发性室性期前收缩患儿的临床资料,按不同年龄组分为婴幼儿期(<3岁),学龄前期组(3~6岁)和学龄期(~16岁),并在不同年龄组内按室性期前收缩来源部位不同,分为右室型组和左室型组;比较分析不同年龄组、不同来源期前收缩组之间HRV与DC各指标的差异。结果三个不同年龄组的DC和HRV时域分析各项参数的差异均有统计学意义(P<0.05)。婴幼儿组中,右室型组和左室型组间相邻RR间期差值的均方根(RMSSD)、高频功率(HF)、低频功率(LF)/HF、DC、相邻RR间期差值50 ms的百分数(PNN50)差异均有统计学意义(P均<0.05);学龄前期组中,右室型组和左室型组间的RMSSD、LF、HF、LF/HF、DC差异有统计学意义(P均<0.05),学龄期组中,右室型组和左室型组间的RMSSD、HF、LF/HF、DC差异均有统计学意义(P均<0.05)。结论特发性室性期前收缩患儿自主神经平衡调节受损,以迷走神经张力的降低为主;起源于优势心室(婴幼儿期及学龄前期患儿以右心室占优势,学龄期患儿左心室为优势心室)的频发室性期前收缩,增加了恶性心律失常发生的风险。
Objective To investigate the relationship between heart rate variability (HRV) and heart rate deceleration (DC) in children with idiopathic ventricular premature contractions. Methods A retrospective analysis of 155 cases of idiopathic ventricular premature contractions in children with clinical data, according to different age groups infants (<3 years old), preschool group (3 to 6 years old) and school age (~ 16 Year-old), and divided into right ventricular group and left ventricular group in different age groups according to the source of premature ventricular contractions; comparative analysis of different age groups, different sources of contractions before HRV and DC indicators The difference. Results The parameters of DC and HRV in three different age groups showed statistically significant differences (P <0.05). In the infants and young children group, RMSSD, HF, LF / HF, DC, and RR of adjacent RR interval differences between right ventricular group and left ventricular group There were significant differences in PNNS50 between the two groups (P <0.05). In the pre-school age group, RMSSD, LF, HF, LF / HF, (P <0.05). There were significant differences in RMSSD, HF, LF / HF, DC between right ventricular group and left ventricular group in school-age group (all P <0.05) . Conclusions Autonomic balance regulation is impaired in children with idiopathic ventricular premature contractions, with the decrease of vagal tone mainly. Right ventricle originated in superior ventricles (infants and preschool children with right ventricular predominance, left Ventricular preponderance of the ventricles of the ventricular contraction, increasing the risk of malignant arrhythmia.