【摘要】 目的 观察慢性肺心病伴短阵室速患者心率变异性(HRV),了解其自主神经功能的变化。方法 102例慢性肺心病患者，根据24h动态心电图有无室速分为室速组(VT组，22例)和无室速组(无VT组，80例)，并与30例正常人作对照(对照组)，作时域和频域分析。结果 (1)肺心病急性加重期患者的时域指标SDNN(正常R-R间期的标准差)、SDANN(每5min正常R-R间期标准差的平均值)、rMSSD均低于对照组，频域指标HF、LF降低，LF/HF明显增高，差异有显著性。(2)肺心病伴短阵室速组患者的SDNN、SDANN、rMSSD(全程相邻正常R-R间期之差的均方根值)、HF亦低于非室速组，差异有显著性。结论 慢性肺心病患者HRV降低，尤其是伴VT患者更为明显，反映了慢性肺心病伴短阵室速患者自主神经调节功能失衡更为明显，更易发生心源性猝死。

    【关键词】 肺心病；心率变异性；自主神经功能；室性心动过速

    An analysis of heart rate variability in patients with chronic cor pulmonale with ventricular tachycardia

    WANG Xing-de,LAI Yi-ping,QIAN Yue-zhen.

    Department of Cardiac Function,Shanghai Punan Hospital,Shanghai 200125,China

    【Abstract】 Objective To observe the change of autonomic nervous system in patients with chronic cor pulmonale with ventricular tachycardia (VT).Methods One hundred and two chronic cor pulmonale patients were divided into VT group (22 cases) and no VT group (NVT group, 80 cases) based on with and without VT in ambulatory electrocardiogram,and 30 healthy subjects (control group) were compared.To analyze the heart rate variability (HRV) between the three groups.Results (1)The SDNN,SDANN,rMSSD,HF in chronic cor pulmonale patients were lower and LF/HF was higher than the control group.(2)The SDNN,SDANN,rMSSD and HF in patients with VT group were lower than that of the NVT group.Conclusion The imbalance of the autonomic nervous system lead to HRV decrease in chronic cor pulmonale patients,especially in patients with VT. ......