冠心病患者和正常人血脂与心率变异性频域指标关系的研究

目的：分析冠心病患者和正常人血脂水平与心率变异频域指标及自主神经活动的关系。方法：对71例确诊的冠心病患者和96例正常人行24h动态心电图并采空腹血查血脂，分别比较两类人群中高胆固醇血症组与正常胆固醇组心率变异频域指标VLF、LF、HF、LF／HF的差异，并用多元逐步回归分析血脂各值与心率变异的相关性。结果：高胆固醇血症组与正常胆固醇组相比，冠心病患者中HF值显著降低（P＜0．05），而LF／HF值显著增高（P＜0．01）；正常人亦有高胆固醇血症组HF值较低而F/HF值较高的趋势，但无统计学差异。多元逐步回归分析中，冠心病患者HF与TC呈负相关，LF／HF则与TC、LDL呈正相关；正常人中LF／HF亦与TC呈正相关。结论：冠心病患者和正常人中血脂水平均与心率变异及自主神经活动存在一定的相关性。胆固醇增高者交感与迷走神经平衡性失调，交感神经活性相对较高而迷走神经活性相对较低。

The Relationship between Plasma Lipids and Frequency Domain Parameters of Heart Rate Variability in CHD and Healthy Men

Objective To analysis the relationship between plasma lipids and frequency domain parameters of heart rate variability, also automic nerve activity in CHD patients and healthy men.Method 71 CHD patients and 96 healthy men received examinations of 24-hour Holter electrocardiogram and blood samples of lipid were taken after overnight fast. Both CHD patients and healthy men were dichotomized according to the total cholesterol (TC) level.Result In CHD patients ,men with TC level above the mean had lower HF(P<0.05)and higher LF/HF (P<0.01);in healthy group, men with TC level above the mean also had lower HF and higher LF/HF, but P value had no statistic significance. Stepwise multiple regression analysis showed that HF inversely correlated to TC while LF/HF negatively correlated to TC and LDL in CHD patients; in healthy men, LF/HF negatively correlated to TC also. Conclusion The data suggest that plasma lipids is in some way correlated to heart rate variability and automic nerve activity. The sympathovagal balance is impaired and the sympathetic activity is relatively higher while vagal activity is relatively lower in men with plasma lipids above the normal level.