刘慧琴

(青海大学附属医院心电图室)



高原地区世居藏族心率减速力检测的临床意义

刘慧琴

(青海大学附属医院心电图室)

摘要目的探讨高原世居藏族DC的变化规律及其临床意义。方法比较西宁地区(海拔2295米)和玉树地区(海拔3681米)不同海拔藏、汉族心率减速力以及24小时最慢心率、平均心率、最快心率的差异性，及多发病与心率减速力的相关性，了解健康及患病组人群迷走神经张力高低的差异性。结果在高原地区世居藏族中，多发病组的DC 值与对照组比较明显减小，差异均有统计学意义(P<0.01)，健康对照组DC值偏高。结论高原地区临床应对患者行DC 常规检测，可以直接量化患者迷走神经张力的高低，利于及时采取适宜干预措施，行双向预后评估，利于分层预警，减少猝死发生率。

关键词心率减速力24小时心电监护自主神经损伤

THE CLINICAL SIGNIFICANCE OF DECELERATION

CAPACITY RATE IN ATHNIC TIBETAN AT HIGH ALTITUDE

Liu Huiqin

(Dept.of Electrocardiography，Qinghai University Affiliated Hospital)

Abstract ObjectiveTo investigate the clinical significance by observing and analyzing the changes of deceleration capacity(DC)in athnic Tibetan at high altitude.Methods Compare the difference of slow heart rate and 24 hours heart rate by slowest，mean，fastest of Han and Tibetan people between Xining with Yushu area.The relation of DC with frequently-occurring disease and of high or low with vagus nerve tension between health and patient in altitude were studied.Results There was statistical significance on DC with frequently-occurring ethnic Tibetan patients compared with control in high altitude area.Conclusion Dealing with patients′s DC usually can quantitate the high or low vagus nerve tension directly in high altitude and to take intervention measures in time.Doing Two-way prognosis′s assessment can quantitate layered alert and reduce the incidence of sudden death.

KeywordsDeceleration capacity rate24 hours ECG Monitoring autonomic nerve damage

心率减速力(deceleration capacity of rate，DC)检测技术是定量评估受检者迷走神经张力高低，进而筛选和预警猝死高危患者的一种新的无创心电技术[1]。DC降低时提示迷走神经的兴奋性降低，相应之下，其对人体的保护性作用下降，使患者猝死的危险性增加。反之，DC正常时，提示迷走神经对人体的保护性较强，受检者属于猝死的低危者[2]。DC 值可以定量检测出心脏自主神经活性，具有快速、无创和简便等优点[3-4]。本研究旨在观察高原世居藏族DC的变化规律，并参照临床表现，探讨其临床意义。

1资料与方法

1.1入组临床资料

选择高原地区世居藏族(玉树地区)多发病病例150例。对照组选择高原地区世居藏族(玉树地区)健康者90 例(男性44例，女性46例)。同时选择西宁地区健康者90例(男性32例，女性58例)，对照组选择世居藏族(玉树地区)健康者90例(男性44例，女性46例)。同时行DC及24小时心电监护检查。……