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目的检测老年人(≥60岁)冠心病(心肌梗死、心绞痛)患者心率变异(HRV)及探讨其临床意义。方法本研究对老年冠心病组(72例)与正常组(26例)的5min心电信号进行HRV对照研究,观察下列指标,总体标准差(SDANN),均值标准差(SDNN)标准差均值(SDNNindex)差值均分的平方根(rMSSD),以及差值>50ms的百分比(PPN50%),并检测5min平均心率(HR)、最大HR和最小HR。结果老年冠心病组HRV各项指标均数较正常组显著降低,冠心病组与正常组5minHR比较,前者最小HR明显增快,最大HR与平均HR则无明显差异。结论老年冠心病(心肌梗死、心绞痛)心肌缺血,心脏自主神经损害,迷走神经功能受损,HRV降低,临床应用β受体阻滞剂可维持植物神经功能平衡状态,改善老年冠心病预后颇有价值。
Objective To detect heart rate variability (HRV) in elderly patients (≥60 years old) with coronary heart disease (myocardial infarction, angina pectoris) and to explore its clinical significance. Methods In this study, HRV control study was performed on 5 min ECG in elderly patients with coronary heart disease (72 patients) and normal patients (26 patients). The following indexes, SDANN, SDNN standard deviation mean ( SDNNindex), and the percentage differences (PPN50%) of> 50ms, mean heart rate (HR), maximum HR, and minimum HR at 5 min were also measured. Results Compared with the normal group, the average number of HRV in elderly patients with coronary heart disease was significantly lower than that in the normal group. The minimum HR was significantly increased in the patients with coronary heart disease compared with the normal group at 5 min. There was no significant difference between the maximum HR and the average HR. Conclusions Elderly coronary heart disease (myocardial infarction, angina pectoris) myocardial ischemia, cardiac autonomic nerve damage, vagal dysfunction, HRV decreased, clinical application of β-blockers can maintain autonomic function balance and improve the prognosis of elderly patients with coronary heart disease value.