重型β-地中海贫血患儿心率变异性的分析

Heart rate variability in children with beta-thalassemia major

摘要:

目的：该研究通过对重型β-地中海贫血（β-TM）患儿心率变异性（HRV）的变化特点的研究，探讨HRV对β-TM患儿心功能异常的诊断价值。方法：对21例β-TM患儿（地贫组）和15例正常儿童（对照组）分别进行24 h动态心电图（Holter）检查，比较分析两组HRV时域和频域指标的变化及β-TM患儿血清铁蛋白水平与HRV的相关性。结果：地贫组患儿HRV时域指标SDNN、rMSSD、pNN50 和频域指标极低频谱（VLF）、低频谱（LF）、高频谱（HF）均降低，与对照组比较差异有统计学意义（P<0.05）；血清铁蛋白水平与HRV的变化无相关性。结论：β-TM患儿自主神经功能异常；HRV对β-TM患儿早期心功能异常有预测价值。

Abstract:

OBJECTIVE: To study the diagnostic value of heart rate variability (HRV) in heart dysfunction in children with beta-thalassemia major (β-TM)by examining the changes of HRV in β-TM children. METHODS: A 24 hours Holter monitoring electrocardiogram (Holter) was performed in 21 children with β-TM and 15 healthy children (control group). The time domain and frequency domain indexes of HRV in the two groups were compared. The correlation between serum ferritin levels and HRV was evaluated. RESULTS: The time domain indexes SDNN, rMSSD and PNN50 and the frequency domain indexes very low frequency (VLF), low frequency (LF) and high frequency (HF) in the β-TM group were significantly lower than in the control group (P<0.05). There was no correlation between serum ferritin level and HRV in children with β-TM. CONCLUSIONS: The autonomic nerve dysfunction exists in children with β-TM. HRV analysis is useful in the prediction of early cardiac dysfunction in children with β-TM.