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中华妇幼临床医学杂志(电子版) ›› 2015, Vol. 11 ›› Issue (02) : 214 -217. doi: 10.3877/cma.j.issn.1673-5250.2015.02.014

所属专题: 文献

论著

川崎病患儿心率变异性的特点分析
陈婷婷1, 石坤1, 柳颐龄1, 杨森1, 李焰1, 王献民1,*,*()   
  1. 1. 610091 成都市妇女儿童中心医院小儿心脏内科
  • 收稿日期:2014-11-04 修回日期:2015-02-16 出版日期:2015-04-01
  • 通信作者: 王献民

Analyze the characteristics of heart rate variability in children with Kawasaki disease

Tingting Chen1, Kun Shi1, Yilin Liu1, Sen Yang1, Yan Li1, Xianmin Wang1()   

  1. 1. Department of Cardiology, Chengdu Women's & Children's Central Hospital, Chengdu 610091, Sichuan Province, China
  • Received:2014-11-04 Revised:2015-02-16 Published:2015-04-01
  • Corresponding author: Xianmin Wang
  • About author:
    Corresponding author: Wang Xianmin, Email:
引用本文:

陈婷婷, 石坤, 柳颐龄, 杨森, 李焰, 王献民. 川崎病患儿心率变异性的特点分析[J/OL]. 中华妇幼临床医学杂志(电子版), 2015, 11(02): 214-217.

Tingting Chen, Kun Shi, Yilin Liu, Sen Yang, Yan Li, Xianmin Wang. Analyze the characteristics of heart rate variability in children with Kawasaki disease[J/OL]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2015, 11(02): 214-217.

目的

探讨川崎病患儿的心率变异性(HRV)特点。

方法

选择2012年10月至2014年8月,成都市妇女儿童中心医院收治的120例川崎病患儿为研究对象,并纳入川崎病组。再按照是否伴冠状动脉扩张,将其进一步分为冠状动脉扩张亚组(CAL亚组,n=46)和无冠状动脉扩张亚组(NCAL亚组,n=74)。随机选择同期于本院接受体检的57例健康儿童纳入对照组。对两组儿童的24 h窦性心律进行HRV分析,并观察时域分析统计指标[正常窦性R-R间期标准差(SDNN)、全部记录中每5 min N-N间期平均值的标准差(SDANN)、相邻N-N间期标准差的平均值(SDNN index)、相邻N-N间期差值的均方根值(rMSSD)、相邻N-N间期之差>50 ms的心搏数占心搏总数的百分率(PNN50)]和频域分析统计指标[极低频功率(VLF)、低频功率(LF)、高频功率(HF)、低频/高频(LF/HF)]。各组患儿的性别构成比、年龄等一般临床病历资料比较,差异无统计学意义(P>0.05)。本研究遵循的程序符合成都市妇女儿童中心医院人体试验委员会制定的伦理学标准,得到该委员会批准,分组征得受试对象监护的人的知情同意,并与之签署临床研究知情同意书。

结果

川崎病组患儿的时域分析统计指标SDNN、SDNN index、rMSSD、PNN50均较对照组降低,且差异均有统计学意义(t=5.82,2.20,4.81,3.64;P<0.05);而两组SDANN比较,差异却无统计学意义(t=1.92,P=0.085)。川崎病组患儿的频域分析统计指标VLF、LF、HF均较对照组降低,LF/HF值较对照组升高,并且差异均有统计学意义(t=2.50,4.50,2.85,2.14;P<0.05)。CAL亚组的SDNN、SDANN、PNN50、LF较NCAL亚组明显下降,并且差异有统计学意义(t=3.38,2.46,2.15,7.92;P<0.05)。

结论

川崎病患儿存在心脏自主神经功能损害,HRV对预测川崎病的发展和预后具有一定价值。

Objective

To explore characteristics of heart rate variability (HRV) in children with Kawasaki disease.

Methods

From October 2012 to August 2014, a total of 120 children with Kawasaki disease were selected into this study (Kawasaki disease group). According to whether complicated with coronary artery expansion or not, Kawasaki disease group were further divided into coronary artery expansion sub-group (CAL sub-group, n=46) and no coronary artery expansion sub-group (NCAL sub-group, n=74). Meanwhile, another 57 children received health examination were selected into control group in this study randomly. The HRV time domain and frequency domain over 24 hours were performed in Kawasaki disease group and control group. HRV time domain measures included standard deviation of N-N intervals(SDNN), standard deviation of all mean 5-minute N-N intervals(SDANN), standard deviation of all N-N intervals for all 5-minute segments of 24 hours(SDNN index), root mean squared successive diference(rMSSD), percent of N-N 50 in the total number N-N intervals(PNN50). HRV frequency domain measures included very low frequency(VLF), low frequency(LF), high frequency(HF), and LF/HF. There were no significant differences between two groups in general clinical data, such as gender constituent ratio, age. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Chengdu Women's & Children's Central Hospital. Informed consent was obtained from the parents of each participating child.

Results

The levels of SDNN, SDNN index, rMSSD and PNN50 of HRV in Kawasaki disease group were significantly lower than those in control group (t=5.82, 2.20, 4.81, 3.64; P<0.05), but there were no significant difference between two groups in the level of SDANN(t=1.92, P=0.085). The levels of VLF, LF, and HF of HRV in Kawasaki disease group were significantly lower than those in control group (t=2.50, 4.50, 2.85; P<0.05), and the level of LF/HF in Kawasaki disease was significantly higher than that in control group (t=2.14, P=0.041). Compare with NCAL sub-group, the levels of SDNN, SDANN, PNN50, and LF decreased progressively in CAL sub-group, and there were significant differences (t=3.38, 2.46, 2.15, 7.92; P<0.05).

Conclusions

Cardiovascular autonomic nervous functional lesion could be found in children with Kawasaki disease. HRV has a certain value to predict the development and prognosis of children with Kawasaki disease.

表1 两组HRV时域分析统计指标比较(±s)
Table 1 Comparison of time domain measures of HRV between two groups (±s)
表2 两组HRV频域分析统计指标比较(±s)
Table 2 Comparison of time frequency domain measures of HRV between two groups (±s)
表3 冠状动脉扩张组与无冠状动脉扩张组患儿心率变异性指标比较(±s)
Table 3 Comparison of HRV measures between coronary artery expansion sub-group and no coronary artery expansion sub-group (±s)
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