急性加重期慢性阻塞性肺疾病患者心率变异性的临床分析(1)
【摘要】 目的：探讨心率变异性(HRV)评估慢性阻塞性肺疾病急性加重(AECOPD)患者的自主神经功能的变化，并分析其临床意义。方法：选取2013年1月-2014年6月在笔者所在医院住院治疗的48例AECOPD患者作为观察组，另选取同期的46例COPD稳定期患者作为对照组。所有患者进行24 h动态心电图检查，分析HRV各项指标：SDNN、SDANN、rMSSD和PNN50等时域指标；高频功率(HF)、低频功率(LF)、超低频功率(ULF)及低频与高频之比(LF/HF)等频域指标。并测定、记录其第一秒用力呼气容积(FEV1)和第一秒用力呼气容积占预计值的百分比(FEV1%)。结果：研究结果显示，观察组的SDNN、SDANN、rMSSD和PNN50分别为(71.47±3.86)ms、(68.64±2.52)ms、(54.29±3.07)ms和(18.16±1.94)%，均明显低于对照组，差异均有统计学意义(P<0.05)；观察组的HF、LF、ULF和LF/HF分别为(49.52±4.01)ms2、(87.55±7.76)ms2、(351.30±25.44)ms2和0.74±0.18，均明显低于对照组，差异均有统计学意义(P<0.05)；观察组患者FEV1和FEV1%分别为(2.18±0.25)L和(81.63±5.84)%，均明显低于对照组，差异均有统计学意义(P<0.05)。结论：AECOPD患者存在自主神经功能损害，HRV时域和频域分析各项评测指标能够较好反映AECOPD患者心率变异性变化，HRV分析有希望作为AECOPD临床监测的有价值指标。
【关键词】 急性加重期慢性阻塞性肺疾病； 心率变异性； 自主神经功能
中图分类号 R563 文献标识码 B 文章编号 1674-6805(2015)17-0028-03
Clinical Analysis of Heart Rate Variability for the Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease/HUANG Zhong，PAN Tao.//Chinese and Foreign Medical Research，2015，13(17)：28-30
【Abstract】 Objective：To investigate the heart rate variability (HRV) for the assessment of the changes of autonomic nervous function of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD)，and analyze its clinical significance.Method：48 AECOPD patients in our hospital from January 2013 to June 2014 were selected as the observation group，46 patients with stable COPD during the same period were selected as the control group.All patients underwent 24 h dynamic electrocardiogram examination.HRV indicators：SDNN，SDANN，rMSSD and PNN50 time domain index.High frequency power(HF)，low frequency power(LF)，the ultra low frequency power(ULF) and the low frequency and high frequency ratio(LF/HF) frequency domain index.The forced expiratory volume in one second (FEV1) and forced expiratory volume in the first second percentage of predicted value (FEV1%) of the two groups were tested and recorded.Result：The results showed that，the SDNN，SDANN，rMSSD and PNN50 of the observation group were (71.47±3.86)ms，(68.64±2.52)ms，(54.29±3.07)ms
and (18.16±1.94)%，which were significantly lower than the control group，the differences were statistically significant(P<0.05).The HF，LF，ULF and LF/HF
of the observation group were (49.52±4.01)ms2，(87.55±7.76)ms2，(351.30±25.44)ms2 and 0.74±0.18，which were significantly lower than the control group，the differences were statistically significant(P<0.05).The FEV1 and FEV1% of the observation group were(2.18±0.25)L and (81.63±5.84)%，which were significantly lower than the control group，the differences were statistically significant(P<0.05).Conclusion：AECOPD patients have autonomic dysfunction，HRV time domain and frequency domain analysis can reflect the change of heart rate variability in patients with AECOPD，HRV analysis can be used as an AECOPD clinical monitoring of value index., http://www.100md.com(黄忠 潘桃)
【关键词】 急性加重期慢性阻塞性肺疾病； 心率变异性； 自主神经功能
中图分类号 R563 文献标识码 B 文章编号 1674-6805(2015)17-0028-03
Clinical Analysis of Heart Rate Variability for the Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease/HUANG Zhong，PAN Tao.//Chinese and Foreign Medical Research，2015，13(17)：28-30
【Abstract】 Objective：To investigate the heart rate variability (HRV) for the assessment of the changes of autonomic nervous function of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD)，and analyze its clinical significance.Method：48 AECOPD patients in our hospital from January 2013 to June 2014 were selected as the observation group，46 patients with stable COPD during the same period were selected as the control group.All patients underwent 24 h dynamic electrocardiogram examination.HRV indicators：SDNN，SDANN，rMSSD and PNN50 time domain index.High frequency power(HF)，low frequency power(LF)，the ultra low frequency power(ULF) and the low frequency and high frequency ratio(LF/HF) frequency domain index.The forced expiratory volume in one second (FEV1) and forced expiratory volume in the first second percentage of predicted value (FEV1%) of the two groups were tested and recorded.Result：The results showed that，the SDNN，SDANN，rMSSD and PNN50 of the observation group were (71.47±3.86)ms，(68.64±2.52)ms，(54.29±3.07)ms
and (18.16±1.94)%，which were significantly lower than the control group，the differences were statistically significant(P<0.05).The HF，LF，ULF and LF/HF
of the observation group were (49.52±4.01)ms2，(87.55±7.76)ms2，(351.30±25.44)ms2 and 0.74±0.18，which were significantly lower than the control group，the differences were statistically significant(P<0.05).The FEV1 and FEV1% of the observation group were(2.18±0.25)L and (81.63±5.84)%，which were significantly lower than the control group，the differences were statistically significant(P<0.05).Conclusion：AECOPD patients have autonomic dysfunction，HRV time domain and frequency domain analysis can reflect the change of heart rate variability in patients with AECOPD，HRV analysis can be used as an AECOPD clinical monitoring of value index., http://www.100md.com(黄忠 潘桃)