nghiên cứu biến thiên nhịp tim theo thời gian và theo phổ tần số ở người bình thường

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NGHIÊN CU BIN THIÊN NHP TIM THEO THI GIAN VÀ THEO PH TN
S  NG

Trn Minh Trí
1
, Hu
2
1

2









Window XP.


HF (ms2) 207.38±23.24 LnHF 4.87±0.10
LF (ms2) 155.29±32.05 LnLF 4.48±4.48
VLF (ms2) 141.93±32.25 LnVLF 4.42±0.09
ULF (ms2) 15.52±1.23 LnULF 2.49±0.08
TF (ms2) 2029.69±309.04 LnTF 7.19±0.09

SDNN , ms 122.89 ± 3.92 ASDNN ,ms 55.69 ± 1.64

SDANN ,ms 110.26 ± 3.59 RMSSD,ms 37.15 ± 2.30






SUMMARY
Heart rate variability has been known to be a prognostic factor of heart disease.
Objectives of this study were to measure heart rate variability in healthy individuals by using
time and frequency methods, and to compare its.
Methods: Heart rate variability measures were obtained by DigiTrak XT and Philips Zymed
Holter 1810 series Version: 2.9.2 software. The HRV was determined from 24-hour Holter
records, using 4 time domain measures (SDNN, ASDNN, SDANN, RMSSD), 5 frequency
domain measures (HF, LF, ULF, VLF, TF)
Results: (1) HRV explored in the frequency domain: HF (ms2) 207.38±23.24, LF (ms2)
155.29±32.05, VLF (ms2) 141.93±32.25, ULF (ms2) 15.52±1.23 and TF (ms2) 2029.69±309.04.
(2) HRV explored in the time domain: SDNN (ms) 122.89 ± 3.92, ASDNN (ms) 55.69 ± 1.64,
SDANN (ms) 110.26 ± 3.59 and RMSSD (ms) 37.15 ± 2.30. (3) there were no significant
difference between male and female in healthy individuals. It was found that the HRV decreases
with age but LF/HF ratio was not changed. There was significant negative correlations of mean
heart rate in 24 hour ambulatory Holter monitoring with the HRV.
Conclusions: The exploration in the frequency domain of cardiovascular neural regulation
might be useful in assessing the clinical progression of the cardiac disease.



 
 


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
              

    

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


:
   




              
Window XP/ Win 7/Vista.





[2]










[2]
HF, ms
2

-thn kinh phó giao cm
LF, ms
2
-
6 giây. Bthn kinh giao cmthn kinh phó giao cm


VLF, ms
2
-
thn kinh giao cmthn kinh phó
giao cm
ULF, ms
2
--

thn kinh giao cm


TF, ms
2
 0  0.4Hz.

516

3.1. Phân b theo gii tính và tui
3.

Nam, n (%)

Nhóm 1 (18  
20 (52.6)
43 (76.8)

18 (47.4)
13 (23.2)
Tu
40.53±12.25
35.16±9.57

38 (100)
56 (100)

m nhp tim trung bình cn tim 24 gi
3.

Nhóm 1 (18  

Chung 2

nhóm
Nam

Nam


bình
74.95
(59-93)
74.44
(51-100)
75.78
(64-92)
76.62
(60-93)
75.11
(51-100)
N
20
43
18
13
94
 
3.3. BTNT theo th ms) vi gii tính và tui
Bảng 3.3. BTNTtheo thời gian và giới tính – nhóm tuổi

Nhóm 1
( 18  
Chung

nhóm 1
Nhóm 2

Chung
nhóm 2
Chung 2
nhóm
Nam

Nam

SDNN

126.96
12.32
127.54
4.80
127.36
5.04
116.32
8.15
110.39
8.31
113.84
5.81
122.89
3.92
SDANN

119.96

9.73
112.64
4.77
114.96
4.47
104.11
8.10
96.03
8.24
100.72
5.79
110.26
3.59
ASDNN

64.32
3.61
56.77
1.96
59.16
1.80
47.53
3.77
50.21
5.28
48.65
3.07
55.69
1.64
RMSSD


39.65
3.46
38.91
3.13
39.14
2.39
28.39
3.50
39.62
10.93
33.10
5.01
37.15
2.30
N
20
43
63
18
13
31
94
  

3.4. BTNT theo ph tn s  ms
2
) vi gii tính và tui

Bảng 4. BTNTtheo phổ tần số và giới tính – nhóm tuổi

Nhóm 1
( 18  
Chung
nhóm 1
Nhóm 2

Chung
nhóm 2

Nam

Nam

LnULF

2.54
0.26
2.55
0.07
2.55
0.09
2.39
0.21
2.37
0.17
2.38
0.14
2.49
0.08

LnVLF

4.50
0.25
4.42
0.07
4.45
0.09
4.48
0.30
4.21
0.29
4.37
0.21
4.42
0.09
LnLF

4.55
0.25
4.60
0.10
4.58
0.10
4.25
0.33
4.29
0.31
4.27
0.23

4.48
0.10
LnHF

4.79
0.30
5.11
0.11
5.01
0.12
4.47
0.31
4.74
0.27
4.59
0.21
4.87
0.10
LnTF

7.24
0.26
7.28
0.09
7.26
0.10
7.03
0.29
7.04
0.26

7.04
0.20
7.19
0.09
LnLF/LnHF

0.98
0.03
0.91
0.02
0.93
0.01
0.95
0.03
0.90
0.03
0.93
0.02
0.93
0.01
N
20
43
63
18
13
31
94
517
 - 

- 
- 
a BTNT và nhp tim trung bình trong 24 gi
Bảng 3.5. Tương quan giữa BTNT và nhịp tim trung bình trong 24 giờ

Ln
SDNN
Ln
SDANN
Ln
ASDNN
Ln
RMSSD
Ln
TF
Ln
HF
Ln
LF
Ln
VLF
Ln
ULF
LnNTTB
-0.46
-0.44
-0.59
-0.62
-0.39
-0.38

-0.22
-0.36
-0.39



4.1. Nh


1


 


resampling)
4.2.1. BTNT theo t

1]. 




[10



- VLF- LF- HF- 



     
angiote
0

11].
         12   






RMSSD/SDNN
0.34 ± 0.03
0.29 ± 0.04
LnLF/HF
0.93±0.01
0.93±0.02







518

3]. Nghiên 
-Hsien Chang [13] là 0.92±0.35.


 


6]


giá BTNT [85

xem xét 

4].

                 8], D.
7




1. Các thông số biến thiên nhịp tim theo phổ tần số
HF (ms
2
) 207.38±23.24
LnHF 4.87±0.10
LF (ms
2
) 155.29±32.05
LnLF 4.48±4.48
VLF (ms
2
) 141.93±32.25

LnVLF 4.42±0.09
ULF (ms
2
) 15.52±1.23
LnULF 2.49±0.08
TF (ms
2
) 2029.69±309.04
LnTF 7.19±0.09
2. Các thông số biến thiên nhịp tim theo thời gian
SDNN, ms
122.89 ± 3.92

ASDNN,ms
55.69 ± 1.64
SDANN,ms
110.26 ± 3.59

RMSSD,ms
37.15 ± 2.30
3. Không có khác biệt về giới tính của biến thiên nhịp tim.
4. Biến thiên nhịp tim giảm dần theo tuổi và sự giảm này vẫn giữ tính cân bằng giữa hệ
thần kinh giao cảm và phó giao cảm.
5. Có tính tương quan nghịch giữa biến thiên nhịp tim và nhịp tim trung bình trong 24 giờ
ghi.
6. Cần áp dụng phân tích phổ trên lâm sàng để đánh giá tiên lượng, phân loại nguy cơ
bệnh nhân tim mạch


 





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tuổi từ 21 – 40. . Đại hội Tim mạch miền trung mở
rộng lần II: 200-203.
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bản đại học Huế.
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