妊娠期室性心律失常发生的类型与心率变异性的关系

李花莲; 杜树国; 杨晓云; 魏欣; 闻捷; 周奕菲

doi:10.13201/j.issn.1001-1439.2018.04.015

妊娠期室性心律失常发生的类型与心率变异性的关系

- 1 湖北省妇幼保健院心脑电图诊断科(武汉, 430072);
- 2 湖北省妇幼保健院产科;
- 3 华中科技大学同济医院心功能科

详细信息

通讯作者: 李花莲,E-mail:498012030@qq.com

中图分类号: R541.7

收稿日期: 2017-11-03

The relationship between the type of ventricular arrhythmia and heart rate variability during pregnancy

- 1 Department of Electrocardiogram and Electroencephalogram;
- 2 Obstetrics Department, HuBei Matermal and Child Health Hospital, Wuhan, 430072, China;
- 3 Cardiac Function Department, Tongji Hospital, Huazhong University of Science and Technology

More Information

Corresponding author: LI Hualian, E-mail: 498012030@qq.com

Received Date: 03 November 2017

摘要

摘要: 目的:观察孕妇室性心律失常中室性并行心律和室性期前收缩的动态心电图特点 (DCG), 并探讨其对心率变异性 (HRV) 的影响。方法:回顾210例室性心律失常及33例正常孕妇的DCG资料, 以时间散点图和Lorenz-RR散点图的图形特征并结合逆向心电图进行诊断, 并对期前收缩起源进行定位, 分为左、右室起源。依据DCG定位将患者分为室性期前收缩组 (左室组、右室组) 59例、室性并行心律组 (左室组、右室组) 151例和对照组33例, 比较各组总心搏数、室性期前收缩数、心律失常指数以及HRV、交感活性和迷走活性方面的差异。结果:妊娠期室性心律失常患者的总心搏数较健康对照者增多 (P＜0.05)。室性并行心律组室性期前收缩数较室性期前收缩组多 (P＜0.05), 但两组在起源点方面的差异并无统计学意义。室性并行心律组与室性期前收缩组HRV相关指标均低于对照组 (均P＜0.05);室性并行心律组各项指标较同侧心室来源的室性期前收缩组明显下降 (均P＜0.05)。结论:妊娠期室性心律失常者的HRV指标均有所下降, 其中右室起源的室性并行心律HRV指标下降更明显;室性期前收缩的构成比高于室性并行心律, 二者的发生可能与自主神经功能改变或妊娠期生理变化相关。
- 室性并行心律 /
- 室性期前收缩 /
- 散点图 /
- 妊娠期
Abstract: Objective: To observe the dynamic electrocardiogram (DCG) characteristics of ventricular parasystole (VPSR) and ventricular premature beat (PVB) in pregnancy, and to explore its effect on heart rate variability (HRV).Method: The DCG data of 210 cases of pregnant women with ventricular arrhythmia and 33 cases of normal pregnant were analyzed retrospectively.With a combination of Lorenz-RR scatter plot, time-RR-interval scatter plot and the reversal technique, the diagnosis was maded and the origin of premature beat can be divided into left and right ventricular source.Included cases were divided into VPSR group (left ventricular subgroup, right ventricular subgroup) (n=151), PVB group (left ventricular subgroup, right ventricular subgroup) (n=59) and control group (n=33), the difference of total number of heart beats, ventricular premature contractions number, arrhythmia index, sympathetic activity and vagal activity between each groups was analyzed.Result: The tatol number of heart beats was significantly increased in VPSR and PVB group than that in control group (P＜0.05).The number of ventricular premature contractions in VPSR group was more higher than than in PVB group (P＜0.05), but there was no difference in the origin.Indexes of HRV in VPSR and PVB group were both decreased compared with those in control group (all P＜0.05), HRV indexes of same ventricular origin in VPSR group were lower than those in PVB group (all P＜0.05).Conclusion: The HRV of patient with ventricular arrhythmia are declined, which in VPSR the right ventricle is more obvious.The occurrence of PVB is higher than that of VPSR, which is related to the change of autonomic nerve function or the physiological changes during pregnancy.
- ventricular parasystole /
- ventricular premature beat /
- scatter plot /
- pregnancy

HTML全文

参考文献(18)

[1]	向晋涛, 景永明, 李方洁.室性并行心律的数学特性与散点图特征及电生理意义[J].中国心脏起搏与心电生理杂志, 2012, 26 (4):292-294.
[2]	向晋涛, 吴肇贵, 景永明, 等.大数据室性并行心律的Lorenz-RR散点图散点图形态特征及电生理意义[J].中国心脏起搏与心电生理杂志, 2016, 30 (1):5-10.
[3]	向晋涛, 李方洁, 杨伶.时间RR间期散点图散点图及其逆向技术[J].中国心脏起搏与心电生理杂志, 2011, 25 (2):445-449.
[4]	鲁志兵, 江洪.不同起源部位室性早搏的心电图特点及消融治疗[J].中国心脏起搏与心电生理杂志, 2011, 25 (1):72-76.
[5]	孙卫红, 李文华.流出道起源室性早搏心电图特征及其对射频消融靶点的判断价值[J].实用心电学杂志, 2016, 25 (3):196-200.
[6]	李花莲.儿童室性并行心律和室性早搏的动态心电图分析[J].中国心脏起搏与心电生理杂志, 2017, 31 (6):385-390.
[7]	Yoshida N, Inden Y, Uchikawa T, et al.Novel transitional zone index allows more accurate differentiation between iopathic right ventricular outflow tract and aortic sinus cusp ventricular arrhythmias[J].Heart rhythm, 2011, 8 (3):349-356.
[8]	Betensky BP, Park RE, Marchlinski FE, et al.The V2 transition ratio:a new electrocardiographic criterion for distinguiishing left from right Ventricular outflow tract tachycardia origin[J].J Am Coll Cardiol, 2011, 57 (22).2255-2262.
[9]	李凡, 李菊香.microRNAs与室性心律失常[J].临床心血管病杂志, 2017, 33 (12):1231-1233.
[10]	徐雪娟, 王凯, 吴倩云, 等.室性期前收缩评估急性心力衰竭患者长期预后的临床价值[J].临床心血管病杂志, 2017, 33 (6):544-549.
[11]	赵圣刚, 江力勤.糖尿病心脏自主神经病变与心律失常[J].临床心血管病杂志, 2014, 30 (8):670-673.
[12]	赵集群.不同孕期妇女甲状腺功能及自身抗体分析[J].国际检验医学杂志, 2015, 36 (10):1412-1413.
[13]	张岩, 郭闯, 李颖.131I治疗对甲状腺功能亢进患者心率变异性的影响[J].中国地方病学杂志, 2011, 30 (4):444-446.
[14]	韦怡春, 江华, 李菊香.肾去交感神经术治疗室性心律失常的研究进展[J].临床心血管病杂志, 2016, 32 (6):540-534.
[15]	Chen JL, Chiu HW, Tseng YJ, et al.Hyperthyroidism is characterized by both increased sympathetic and decreased vagal modulation of heart rate:evidence from spectral analysis of heart rate variability[J].Clin Endocrinol, 2006, 64 (6):611-616.
[16]	李智.486例健康妇女妊娠期心电追踪观察与分析[J].吉林医学, 2011, 54 (36):7682-7683.
[17]	马一鸣, 时向名, 陈琪.右室流出道不同部位起源室性早搏患者射频消融术后心率变异性变化的研究[J].海南医学院学报, 2017, 23 (4), 452-455.
[18]	侯月梅, 沈军辉, 李磊.276例无症状室性早搏体表心电图特征与起源分析[J].中国心脏起搏与心电生理杂志, 2013, 27 (6), 489-492.