正常儿童动态心电图窦性心率及心率变异分析

目的探讨正常儿童心率及心率变异性(HRV)特点。方法对804例正常儿童进行24h全程动态心电图检查,分析心率及HRV。结果不同年龄儿童窦性心率范围不同,年龄越小心率越快;儿童不同性别间HRV中24h内全部正常心动周期的标准差(SDNN)、24h内每5minNN间期标准差的平均值(SDNNindex)、NN50占所有N-N间期个数的百分数(PNN50)、极低频率(VLF)、低频(LF)差异有显著性;儿童不同年龄组间24h内5min节段平均心动周期的标准差(SDANN)、VLF、LF、全程相邻NN间期之间的均方根值(rMSSD)差异有显著性;儿童组与成人正常参考值中SDNN、SDANN、rMSSD差异有显著性,rMSSD儿童组中明显高于成人组。结论HRV是一种反映自主神经活性及其平衡的能定量、可重复的非侵入性的检测方法,是自主神经系统与心血管系统相互制约的结果。不同年龄、不同性别间儿童HRV存在显著差异;儿童组与成人参考值存在显著差异,尤其rMSSD儿童明显高于成人,提示儿童的自主神经功能较成人活跃,而随着年龄增长自主神经功能减退,尤其是迷走神经的紧张抑制功能明显减退。

The characteristics of heart rate and heart rate variability in children

Objectives To assess heart rate (HR) and heart rate variability (HRV) in healthy children. Methods Continuous electrocardiographic monitorization by 24- hour Holter recordings was performed in 804 healthy children. Results Sinus rhythm varied among different ages in children. Heart rate decreased while children's age increased. Significant differences of SDNN,SDNN index,PNN50,VLF and LF were shown between male and female. SDANN,VLF,LF and rMSSD changed significantly among different age groups. Significant differences were found in SDNN,SDANN and rMSSD between children and adults. rMSSD was significantly higher in children than in adults. Conclusions HRV indicates the activity of autonomic nervous system. SDANN,SDNNindex,VLF and LF reflect sympathetic nerve activity,while PNN50,HF and rMSSD reflect parasympathetic nerve activity. HRV varied significantly with gender and age and the activity of the autonomic nervous system decreased with age.