目的 探究某部官兵无症状性心律失常的筛查与干预对策。方法 收集某部2019-12至2021-12无症状性心律失常官兵80例作为观察组,另选取50例体检、听诊心律规则的官兵作为对照组。对80例无症状心律失常患者的类型构成进行分析,对比两组心率变异性(HRV)指标,即相邻正常R-R间期差值＞50 ms的%(PNN50)、24 h正常R-R间期的标准差(SDNN)、每5 min的平均NN间期的标准差(SDANN)、相邻正常R-R间期差值的均方根(RMSSD)、NN间期的个数除以NN期间直方图的高度(HRV三角指数))及动态血压[总体平均收缩压(mSBP)、总体平均舒张压(mDBP)、白天平均收缩压(dSBP)、白天平均舒张压(dDBP)、夜间平均收缩压(nSBP)、夜间平均舒张压(nDBP)]的差异,观察两组超声检查结果。结果 (1)80例中良性室性期前收缩占比最高,为61.25%(49/80);(2)观察组PNN50(3.29%±1.50%)、SDNN[(160.02±43.38)ms]、SDANN[(146.58±41.10)ms]、RMSSD[(33.65±13.34)ms]、HRV三角指数(45.77±13.36)水平均明显低于对照组[(11.05%±5.39%),(247.21±51.35)ms,(238.50±59.78)ms,(61.10±20.17)ms,57.94±15.32],差异有统计学意义(P<0.05);(3)观察组mSBP[(117.35±8.94)mmHg]、mDBP[(67.47±5.38)mmHg]、dSBP[(125.98±10.35)mmHg]、dDBP[(74.33±8.25)mmHg]、nDBP[(62.45±4.84)mmHg]水平均显著高于对照组[(112.32±7.89),(64.31±4.29),(121.05±7.99),(70.78±5.90),(59.32±3.65)mmHg],差异有统计学意义(P<0.05);(4)心脏超声心动图检测结果均未发现心房及心室增大、肺动脉高压。结论 部队官兵的无症状性心律失常表现为心率变异性的降低与动态血压的升高,应及时采取针对性的防治措施。
Abstract
Objective To explore the screening and intervention Methods of asymptomatic arrhythmia in officers and soldiers of a certain army.Methods The data of 80 officers and soldiers with asymptomatic arrhythmia in a certain army from December 2019 to December 2021 were collected, and 50 officers and soldiers with physical examination and auscultation rules were selected as the control group; Analysis and comparison of heart rate variability (HRV) indicators was made, such as the percent of the difference between adjacent normal RR intervals>50 ms (pNN50), 24h normal RR interval standard deviation (SDNN), average NN per 5min The standard deviation of the interval (SDANN), the root mean square of the difference between adjacent normal RR intervals (RMSSD), the number of NN intervals divided by the height of the histogram during the NN period (HRV triangle index) and the overall differences of ambulatory blood pressures [mean systolic blood pressure (mSBP), overall mean diastolic blood pressure (mDBP), mean daytime mean systolic blood pressure (dSBP), mean daytime mean diastolic blood pressure (dDBP), mean nighttime mean systolic blood pressure (nSBP), and mean nighttime mean diastolic blood pressure (nDBP) ]. The Results of ultrasonography in the two groups were observed.Results Among the 80 patients with asymptomatic arrhythmia, benign premature ventricular contractions accounted for the highest proportion, 61.25% (49/80); PNN50 (3.29%±1.50%), SDNN[(160.02±43.38)ms], SDANN [(146.58±41.10)ms], RMSSD[(33.65±13.34)ms], HRV triangular index (45.77±13.36) in the observation group were significantly lower than those in the control group [(11.05%±5.39%), (247.21±51.35)ms, (238.50±59.78)ms, (61.10±20.17)ms, 57.94±15.32], P＜0.05; the levels of mSBP [(117.35±8.94)mmHg], mDBP [(67.47±5.38)mmHg], dSBP [(125.98±10.35)mmHg], dDBP[(74.33±8.25)mmHg] and nDBP [(62.45±4.84)mmHg] in the observation group were significantly higher than those in the control group [(112.32±7.89), (64.31±4.29), (121.05±7.99), (70.78±5.90), (59.32±3.65) mmHg], P＜0.05; the echocardiography Results of all officers and soldiers showed that no atrial and ventricular enlargement and pulmonary hypertension were found.Conclusion The asymptomatic arrhythmia of soldiers in the army is manifested as a decrease in heart rate variability and an increase in ambulatory blood pressure, and targeted preventive measures should be taken in time.
关键词
部队官兵 /
无症状性心律失常 /
心率变异性 /
动态血压 /
超声心动图
Key words
military officers and soldiers /
asymptomatic arrhythmias /
heart rate variability /
ambulatory blood pressure /
echocardiography
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参考文献
[1] 葛贝贝, 许 迪, 张艳娟,等. 超声评价心律失常患者左心室舒张功能的研究进展[J]. 中华超声影像学杂志, 2019, 28(10):915-920.
[2] Stringer B F, Nasir U, J Kunkes, et al. Single-center Analysis of success, safety and arrhythmia recurrence after direct current cardioversion and tranesophageal echocardiogram for atrial fibrillation [J]. J Am Coll Cardiol, 2021, 77(18):381.
[3] 陈子良, 刘 彤. 2018年欧洲心律学会心律失常性别差异专家共识解读[J]. 中国循证心血管医学杂志, 2019, 11(4):385-386
[4] 向 丽, 张维贞, 黄 山,等. 心肌纤维化主要标志物在心律失常不同类型中的鉴别作用临床价值探讨[J]. 贵州医药, 2019, 43(1):28-30
[5] 刘 辉,钱真真,栗 洋,等.基于文献计量学的近10年CNKI缓慢性心律失常高被引论文共词分析[J]. 中国循证心血管医学杂志, 2021, 13(3):274-279.
[6] 崔东岳, 范西真, 吴晓飞. 急性心律失常识别与管理[J]. 中华全科医学, 2021, 19(6):892-893.
[7] 齐书英, 汝磊生, 彭育红,等. 高强度训练对部队官兵心电图现象的影响[J]. 中国心脏起搏与心电生理杂志, 2020, 34(6):573-577.
[8] 吕俊刚, 张 琳, 赵 丽,等. 军事训练中官兵心源性猝死预防的探讨[J]. 人民军医, 2021, 64(9):838-841,846.
[9] 柴青芬, 刘 超, 姚胜银,等. 急进高原官兵左心室舒张功能的变化研究[J]. 重庆医学, 2021, 50(1):84-87.
[10] 胡 凯,陈颖敏,卜 军,等. Smartpatch长时程动态心电图监测对心律失常的诊断价值[J]. 中国心脏起搏与心电生理杂志,2019,33(1):17-20.
[11] 王 娇,李 慧. 动态心电图监测传导阻滞与窦房结功能不良患者起搏器植入术后的临床研究[J]. 贵州医药, 2020, 44(11):1715-1716.
[12] 张海澄. 远程心电监测在无症状心律失常管理中的作用[J]. 中国心血管病研究, 2020, 18(8):679-682.
[13] Davila M I, Kizakevich P N, Eckhoff R, et al. Use of mobile technology paired with heart rate monitor to remotely quantify behavioral health markers among military reservists and first responders[J]. Mil Med, 2021,186(Suppl 1):17-24.
[14] 李 鹏, 谢慎威, 向 彬,等. 应用不同指标评价常驻高原军人有氧运动能力的适宜性比较[J]. 第三军医大学学报, 2020, 42(6):588-593.
[15] 姚 焰. 2019 EHRA无症状性心律失常管理的专家共识解读[J]. 中国循环杂志, 2019, 34(S01):31-33.
[16] 曹晓芸, 彭育红,马彦卓,等. 部队官兵高强度训练前后心率及血压与心理指标间关系的探究[J]. 中国循证心血管医学杂志, 2021, 13(1):29-33.
[17] 贺业恒. 少年运动员心脏自主神经训练适应规律与运动能力关系的纵向研究[J]. 天津体育学院学报, 2021, 36(3):366-372.
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