儿童非器质性室性早搏负荷量 与心率变异性的相关性研究

Correlation analysis of non-organic premature ventricular contractions of different burden and the heart rate variability

摘要:

目的 探讨儿童非器质性室性早搏负荷量与心率变异性（HRV）的关系。方法 选取2016 年 10 月—2018 年5 月于郑州大学第一附属医院就诊的144 例非器质性室性早搏（以下简称室早）儿童的临床资料， 根据年龄分为婴幼儿组（<3 岁）、学龄前组（3 ～ 6 岁）及学龄组（7 ～ 16 岁）。比较各组不同非器质性室早 负荷量早搏间HRV 指标差异。结果 婴幼儿组高负荷组LF、HF 及LF/HF 均低于其余两组（P <0.05）。学 龄前组的不同室早负荷量组SDNN、SDANN、LF 及LF/HF 比较，差异有统计学意义（P <0.05）。学龄组高 负荷组LF、HF 及LF/HF 均低于其余两组（P <0.05）。婴幼儿组室早负荷量与SDNN、SDANN、RMSSD、 LF、HF 及LF/HF 呈负相关（r s=-0.463、-0.584、-0.527、-0.711、-0.484、和-0.686，P <0.05）；学龄前组 室早负荷量与SDNN、SDANN、LF 及LF/HF 呈负相关（r s=-0.422、-0.299、-0.412 和-0.505，P <0.05）； 学龄组室早负荷量与SDNN、LF、HF 及LF/HF 呈负相关（r s=-0.432、-0.509、-0.299 和-0.556，P <0.05）。 结论 儿童非器质性室性早搏患儿随室早负荷量增加，自主神经系统功能受损加重，交感- 迷走神经平衡状 态紊乱加重。

Abstract:

Objective To explore the relationship between non-organic premature ventricular contractions (PVCs) of different burden and the heart rate variability (HRV) in children. Methods The clinical data from 144 children with non-organic premature ventricular contractions (PVCs) were retrospectively analyzed. According to the age, the children were divided into young children group (<3 years old), preschool age group (3 ～ 6years old) and school age group (6 ～ 16years old). Each group was divided into low-burden group (1% ～ 10%), medium-burden group (10% ～ 20%) and high-burden group (>20%) according to different mount of PVCs burden. The difference of HRV was compared among groups. Results In the young children group and school age group, the LF, HF and LF/ HF were lower in high burden group than those in other groups (P < 0.05). In the preschool age group, the SDNN, SDANN, LF, LF/HF were apparent different among different burden groups (all P < 0.05). There is a negative correlation between the amount of PVCS and SDNN, SDANN, RMSSD, LF, HF, LF/HF in the young children group (r s =-0.463, -0.584, -0.527, -0.711, -0.484, -0.686, all P < 0.05). There is a negative correlation between the amount of PVCS and SDNN, SDANN, LF, LF/HF in the preschool age group (r s =-0.422, -0.299, -0.412, -0.505, all P < 0.05). There is a negative correlation between the amount of PVCS and SDNN, HF, LF, LF/HF in the school age group (r s =-0.432, -0.509, -0.299, -0.556, all P < 0.05). Conclusions As the burden of PVCs grows, cardiac autonomic system and heart rate turbulence of the children with non-organic premature ventricular contractions (PVCs) become worse.