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目的探讨窦性心率震荡(heart rate turbulence,HRT)对室性早搏儿童发生终点事件的风险预测价值。方法将71例未经治疗的室性早搏儿童分为心源性疾病组(A组)、良性室性早搏组(B组)。采用12导联动态心电图分析仪对各组患儿HRT,包括震荡初始(Turbulence Onset,TO)和震荡斜率(Turbulence slop,TS)进行自动分析,并记录是否发生终点事件,对数据进行统计分析。结果 A组TO较B组高(-0.019±0.025vs-0.029±0.045),A组TS较B组略低(5.84±6.06 ms/RR vs 6.01±6.57 ms/RR),但无统计学差异(t=-1.040,p=0.302;t=0.118,p=0.906)。12例(16.9%)患儿发生终点事件,均为A组患儿,A组内9例TO异常者,发生终点事件7例,明显高于TO正常者(77.8%vs 23.8%,χ~2=5.562,p=0.018)。71例患儿TO异常者21例,其终点事件发生率亦高于正常者(33.3%vs 10.0%,χ~2=4.192,p=0.041)。结论儿童心源性疾病时HRT现象减弱,TO异常者发生终点事件的几率升高,提示HRT对于合并室性早搏的器质性心脏病及终点事件具有预测意义,且无创易行,可于临床推广。
Objective To investigate the risk prediction value of sinus rate heart rate turbulence (HRT) in the event of premature ventricular contractions in children with premature ventricular contractions. Methods 71 cases of untreated premature ventricular contractions were divided into cardiogenic disease group (A group) and benign premature ventricular contractions group (B group). HRT, including Turbulence Onset (TO) and Turbulence slop (TS), were analyzed automatically with a 12-lead ambulatory electrocardiogram analyzer and recorded for end points and statistical analysis of the data. Results Compared with group B, the TO in group A was slightly lower (5.84 ± 6.06 ms / RR vs 6.01 ± 6.57 ms / RR) than that in group B, but there was no significant difference (P> 0.05) t = -1.040, p = 0.302; t = 0.118, p = 0.906). Of the 12 children (16.9%), 12 cases (16.9%) had end point events, all of which were children in group A. Nine patients with TO abnormalities in group A had terminal events in 7 patients, which were significantly higher than those in normal TO children (77.8% vs 23.8%, χ ~ 2 = 5.562, p = 0.018). Twenty-one of 71 children with TO abnormalities had a higher incidence of endpoints than those with normal controls (33.3% vs 10.0%, χ ~ 2 = 4.192, p = 0.041). Conclusions The HRT phenomenon in children with cardiogenic disease is weakened, and the chance of end-point event in TO abnormalities is increased, which indicates that HRT has predictive value for organic heart disease and end point with premature ventricular contractions. Promotion.