【摘要】：目的:探究與分析擴(kuò)張型心肌病患者惡性室性心律失常與心率變異性的相關(guān)性。方法:選取我院自2015年1月至2017年1月收治的90例擴(kuò)張型心肌病患者作為觀察組,另選擇同時(shí)期收治的來(lái)我院體檢的90例正常成年人作為對(duì)照組,采用24h動(dòng)態(tài)心電圖對(duì)兩組患者的心率變異性以及惡性室性心律失常發(fā)生情況,按照是否發(fā)生了惡性心律失常將觀察組分為惡性室性心律失常陽(yáng)性組(n=47例)與惡性室性心律失常陰性組(n=43例),對(duì)比各組心率的差異,探討擴(kuò)張型心肌病患者惡性室性心律失常與心率變異性的相關(guān)性。結(jié)果:對(duì)照組與觀察組性別、年齡、病程、收縮壓、舒張壓、心率、血清鈉、血清鉀、血清鈣及空腹血糖相比無(wú)明顯差異(P0.05)。觀察組與對(duì)照組相比血肌酐升高,尿酸升高,前體N末端前腦利鈉肽升高,心功能分級(jí)升高,左室射血分?jǐn)?shù)低,左室舒張末內(nèi)徑高,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。惡性室性心律失常陽(yáng)性組與惡性心律失常陰性組的性別、年齡、病程、收縮壓、舒張壓、心率、血清鈉、血清鉀、血清鈣及空腹血糖相比無(wú)明顯差異(P0.05)。惡性室性心律失常陽(yáng)性組與惡性心律失常陰性組相比血肌酐升高,尿酸升高,前體N末端前腦利鈉肽升高,心功能分級(jí)升高,左室射血分?jǐn)?shù)低,左室舒張末內(nèi)徑高,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。觀察組與對(duì)照組相比SDNN低、SDANN低、r MSSD低、PNN50高,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。惡性室性心律失常陽(yáng)性組與惡性室性心律失常陰性組SDNN低、SDANN低、r MSSD低、PNN50高,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。對(duì)照組、惡性室性心律失常陰性組及惡性室性心律失常陽(yáng)性組,隨著病情的加重SNDD、SDANN、r MSSD隨之降低,PNN50升高,呈現(xiàn)出明顯的相關(guān)性(P0.05)。結(jié)論:心率變異性可作為一種重要的指標(biāo)用來(lái)預(yù)測(cè)擴(kuò)張型心肌病患者惡性室性心律失常的發(fā)生情況,當(dāng)心率變異性降低時(shí)可與擴(kuò)張型心肌病惡性室性心律失常的發(fā)生有關(guān)。
[Abstract]:Objective: to investigate and analyze the relationship between malignant ventricular arrhythmia and heart rate variability in patients with dilated cardiomyopathy. Methods: 90 patients with dilated cardiomyopathy treated in our hospital from January 2015 to January 2017 were selected as observation group, and 90 healthy adults admitted to our hospital during the same period as control group. Heart rate variability (HRV) and the incidence of malignant ventricular arrhythmias were studied by 24 h ambulatory electrocardiogram (ECG). According to whether malignant arrhythmia occurred, the observation group was divided into positive group (n = 47) and negative group (n = 43). To investigate the relationship between malignant ventricular arrhythmia and heart rate variability in patients with dilated cardiomyopathy. Results: there was no significant difference in sex, age, course, systolic blood pressure, diastolic blood pressure, heart rate, serum sodium, serum potassium, serum calcium and fasting blood glucose between the control group and the observation group (P0.05). Compared with the control group, the serum creatinine, uric acid, precursor N-terminal forebrain natriuretic peptide, cardiac function grade, left ventricular ejection fraction and left ventricular end-diastolic diameter were significantly higher in the observation group than in the control group (P0.05). There was no significant difference in sex, age, course of disease, systolic blood pressure, diastolic blood pressure, heart rate, serum sodium, serum potassium, serum calcium and fasting blood glucose between positive group and negative group (P0.05). Serum creatinine, uric acid, precursor N-terminal forebrain natriuretic peptide, cardiac function grade, left ventricular ejection fraction and left ventricular end-diastolic diameter were increased in malignant ventricular arrhythmia positive group compared with those in malignant arrhythmia negative group. The difference was statistically significant (P0.05). Compared with the control group, the SDNN of the observation group was lower than that of the control group (P0.05). There was a significant difference between the positive group of malignant ventricular arrhythmias and the negative group of malignant ventricular arrhythmia (P 0.05). The SDNN low SDANN low r MSSD low PNN50 was higher in the malignant ventricular arrhythmia positive group than that in the malignant ventricular arrhythmia negative group (P0.05). In control group, negative group of malignant ventricular arrhythmias and positive group of malignant ventricular arrhythmia, with the exacerbation of the disease, the SDANNNr MSSD decreased with the increase of PN50, showing a significant correlation (P0.05). Conclusion: heart rate variability can be used as an important index to predict the occurrence of malignant ventricular arrhythmias in patients with dilated cardiomyopathy, and may be related to the occurrence of malignant ventricular arrhythmias in dilated cardiomyopathy when heart rate variability decreases.
【學(xué)位授予單位】：西安醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R542.2;R541.7

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