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【目的】分析24 h动态心电图监测屏气发作（BHS）患儿心率变异性（HRV），评估自主神经失调对BHS患儿的影响。【方法】选择本院收治的36例BHS患儿，根据入院后患儿的表观体征将其分为紫绀型组（ n ＝24）和苍白型组（ n ＝12），选择同期本院健康体检的24例健康婴幼儿为对照组。通过24 h动态心电图观察受试者的 HRV相关指标，评估BHS患儿自主神经失调对BHS患儿的影响。【结果】苍白型组患儿心率显著低于紫绀型组及对照组，差异具有统计学意义（ P ＜00．5）；苍白型组患儿 HRV时域和频域相关指标所有N‐N间期标准差、5 m in内N‐N间期标准差的平均值、高频功率谱、低频功率谱与高频功率谱比值与紫绀型组及对照组比较差异均具有统计学意义（ P ＜00．5）。【结论】24 h动态心电图监测BHS患儿HRV ，特别对苍白型BHS患儿心脏节律变化的评估至关重要。“,”Objective] To analyze the heart rate variability (HRV) in breath‐holding children by using 24 hour Holter monitoring and evaluate the effect of autonomic dysregulation on children with breath‐holding spells (BHS) .[Methods]36 children with BHS were enrolled and allocated to the cyanotic group ( n =24) and the pallid group ( n =12) according to the symptoms .At the same time ,24 healthy children were also chosen as the control group .By recording the HRV indexes with 24 hour Holter monitoring ,the effect of the auto‐nomic function on the children with BHS was assessed .[Results] The heart rates of the children in pallid group were significantly lower than those of the cyanotic group and the control group ;the difference was sta‐tistically significant ( P <0 0.5) .The time domain and frequency domain indexes for HRV ,including standard deviation of all N‐N intervals ,mean of the standard deviations of all N‐N intervals for all 5‐minute segments , high frequency power spectrum ,low frequency power spectrum ,and the ratio of high frequency power spec‐trum to low frequency power spectrum were all significantly different from those of the cyanotic group and the control group;all differences were statistically significant ( P <0 0.5) .[Conclusions]24 hour Holter monito‐ring for HRV in children with BHS ,particularly in children with pallid spells ,is crucial for evaluation of car‐diac rhythm changes .