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目的探讨应激性心律失常发生的情况以及自主神经对其的影响。方法 60例心律失常患者,随机分为应激组(不给予药物干预)与药物干预组(给予药物干预),各30例,另选30例健康志愿者为对照组。对比各组临床表现。结果与对照组室上性期外收缩(SVPB)(28.5±4.6)个/h、室性期前收缩(SVT)(10.6±3.1)阵/24 h以及室性期前收缩(VBP)(0.7±0.2)个/h相比,应激组(102.5±10.9)个/h、(32.4±6.1)阵/24 h、(10.5±1.8)个/h以及药物干预组(59.7±8.9)个/h、(18.8±4.2)阵/24 h、(4.6±1.2)个/h明显增多,差异有统计学意义(P<0.05)。与药物干预组相比,应激组SVBP、SVT以及VBP情况较多(P<0.05)。与对照组窦性R-R间期标准差(SDANN)(181.4±20.1)ms及连续窦性R-R差值均方根(rM SSD)(45.8±5.7)ms相比,应激组(113.6±17.3)ms、(24.5±5.8)ms和药物干预组(142.4±15.7)ms、(34.2±4.2)ms明显降低,差异有统计学意义(P<0.05)。与药物干预组相比,应激组SDANN及rM SDD指标明显较低(P<0.05)。结论应激性心律失常患者存在着交感神经兴奋,自主神经活动生理调节能力丧失,进而导致一系列的临床表现。
Objective To investigate the occurrence of stress arrhythmia and its effects on autonomic nervous system. Methods Sixty patients with arrhythmia were randomly divided into stress group (without drug intervention) and drug intervention group (with drug intervention), 30 cases each, and 30 healthy volunteers as control group. Compare the clinical manifestations of each group. Results Compared with control group, SVPB (28.5 ± 4.6) / h, SVT (10.6 ± 3.1) / 24 h, and ventricular premature contractions (VBP) (102.5 ± 10.9) /h, (32.4 ± 6.1) g / 24 h, (10.5 ± 1.8) / h and (59.7 ± 8.9) h, (18.8 ± 4.2) mm / 24 h and (4.6 ± 1.2) h / h respectively. The difference was statistically significant (P <0.05). Compared with the drug intervention group, stress group SVBP, SVT and VBP more (P <0.05). Compared with SDANN (181.4 ± 20.1) ms and control rms (rM SSD) (45.8 ± 5.7) ms in the control group, the stress group (113.6 ± 17.3) (24.5 ± 5.8) ms and drug intervention group (142.4 ± 15.7) ms and (34.2 ± 4.2) ms respectively. The difference was statistically significant (P <0.05). Compared with the drug intervention group, SDANN and rM SDD indicators of stress group were significantly lower (P <0.05). Conclusions The patients with stress arrhythmia have sympathetic nerve excitement and loss of autonomic nervous system physiological regulation, leading to a series of clinical manifestations.