【摘要】 目的探讨特发性室性早搏(室早)的发生与自主神经机制之间的关系。方法采用单中心回顾性研究方法,选择24 h动态心电图记录到频发室早(≥10 000次/d或室早负荷≥10%)的156例特发性室早患者(室早组)和同期健康体检者84例(对照组)为研究对象。根据24 h动态心电图检查结果,计算心率变异性指标r MSSD、pNN50、高频功率(HF)、标准化的高频功率(HFnorm)、低频功率(LF)与HF的比值(LF/HF)。比较两组自主神经张力间的差异,并分析室早负荷与自主神经张力变化的关系。结果与对照组相比,室早组患者r MSSD、pNN50、HF和HFnorm均明显增加(P <0.01),LF/HF显著降低(P <0.01)。室早组患者24 h室早负荷与r MSSD、p NN50和HF呈正相关(相关系数分别为0.492、0.425、0.372,P <0.01),而与LF/HF呈负相关(相关系数为-0.206,P <0.05);其中28.8%(45/156)的患者每小时室早负荷与每小时HFnorm呈正相关,16.0%(25/156)的患者与每小时LF/HF呈正相关,53.8%(84/156)的患者与每小时HFnorm和每小时LF/HF均无相关性。结论部分特发性室早的发生与交感和(或)迷走神经张力变化相关。更多还原

【Abstract】 Objective To investigate the relationship between the occurrence of idiopathic premature ventricular contraction（IPVC）and the mechanism of autonomic nerve. Methods In a single-center retrospective study approach,we selected 156 patients with IPVC [PVC group,with ≥10 000 times of PVCs per day recorded by 24-hour ambulatory electrocardiography（AECG）or PVC burden≥10% ],and 84 physical examination subjects during the same period（control group）as research subjects. According to the 24-hour AECG examination results,the following heart rate variability indexes were calculated,including r MSSD,p NN50,HF,HFnorm and LF/HF.We compared the autonomic nervous tension between the two groups,and analyzed the relationship between PVC burden and changes of autonomic nervous tension. Results The indexes of r MSSD,pNN50,HF and HFnorm in the PVC group are all significantly higher than those in the control group（P < 0. 01）while LF/HF is significantly lower（P < 0. 01）. In the PVC group,the 24-hour PVC burden is positively correlated with r MSSD,pNN50 and HF（correlation coefficient r = 0. 492,0. 425 and 0. 372,respectively; P < 0. 01）while it is negatively correlated with LF/HF（r =-0. 206,P < 0. 05）. Hourly PVC burden is positively correlated with hourly HFnorm in 28. 8%（45/156）of the enrolled IPVC patients,and it is positively correlated with hourly LF/HF in 16. 0%（25/156）of IPVC patients. Among 53. 8%（84/156）of IPVC patients,hourly PVC burden is correlated with neither hourly HFnorm nor hourly LF/HF. Conclusion In parts of patients,the occurrence of IPVC is associated with the changes of sympathetic and（or）parasympathetic nervous tension.更多还原