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目的观察遥测心电监护系统心率变异性(HRV)分析在不同心血管疾病中的变化,评价遥测监护系统HRV检测的临床应用价值。方法入选160例在我院诊治的患者,其中正常组40例,急性心肌梗死组40例,高血压病组40例,糖尿病组40例,使用装载心率变异性分析软件的心电监护仪,进行心率变异监测,应用时域法分析HRV各项指标(SDNN、RMSSD、PNN50),观察各组患者与正常组心率变异性各指标的差异,比较急性心肌梗死后不同时间心率变异性的变化,分析心率变异性与室性心律失常的关系。结果心肌梗死组及糖尿病组患者心率变异性各指标较正常组明显降低(p<0.05),高血压组HRV时域指标SDNN较正常对照组降低明显(p<0.05),而RMSSD、PNN50与正常对照组比较差异无统计学意义(p>0.05)。急性心肌梗死组中,发病初期及第2周后短程心率变异性较正常对照组均明显降低,发生严重室性心律失常患者较未发生者明显降低(p<0.05)。结论遥测监护系统心率变异性时域指标降低可敏感地反映自主神经受损程度,可用于心血管疾病的病情预测和疗效评价,并指导临床治疗。
Objective To observe the changes of heart rate variability (HRV) analysis of telemetry ECG in different cardiovascular diseases and evaluate the clinical value of HRV detection in telemetric monitoring system. Methods A total of 160 patients were selected for diagnosis and treatment in our hospital. Among them, 40 patients in normal group, 40 patients in acute myocardial infarction group, 40 patients in hypertension group and 40 patients in diabetes group were enrolled in this study. ECG monitor with heart rate variability analysis software Heart rate variability monitoring, time domain analysis of various indicators of HRV (SDNN, RMSSD, PNN50), observed in each group of patients with normal heart rate variability of each index differences in heart rate variability after different time of acute myocardial infarction compared analysis Relationship between heart rate variability and ventricular arrhythmia. Results The heart rate variability index of myocardial infarction group and diabetic group was significantly lower than that of normal group (p <0.05). HRN time-domain index SDNN in hypertensive group was significantly lower than that in normal control group (p <0.05), while RMSSD, PNN50 and normal There was no significant difference in the control group (p> 0.05). In the acute myocardial infarction group, the short-range heart rate variability in the early and second week after onset was significantly lower than that in the normal control group, and the incidence of severe ventricular arrhythmia was significantly lower than that in the non-infarcted group (p <0.05). Conclusions The reduction of the time-domain index of heart rate variability in telemetric monitoring system can reflect the degree of autonomic nerve damage sensitively, and it can be used to predict the disease status and evaluate the curative effect of cardiovascular disease and guide the clinical treatment.