目的 探讨颈动脉粥样硬化累及或未累及颈动脉窦的老年患者心率变异性的关系.方法 将住院患者根据是否存在颈部动脉粥样硬化斑块分为两组,并全部行24小时动态心电图(DCG)检查.对照组共50例,年龄60～75岁,化验血糖、血脂正常,X线胸片未见异常,血管超声未见颈部动脉血管粥样硬化斑块.患者组共45例,62～83岁,颈部血管超声提示有颈动脉粥样硬化斑块,其中31例累及颈动脉窦.超声检查采用GE System Five彩色超声诊断系统.DCG仪为美国DMPv型三通道分析系统.分析指标:SDNN、SDANN、SDNNindex、rMSSD、PNN50%等.应用t检验方法,分析各指标之间的差异.结果 对照组与患者组HRV对比,患者组SDNN、SDANN明显低于对照组(P<0.05和P<0.01);患者组颈动脉粥样硬化累及和未累及颈动脉窦者HRV对比SDNN,rMSSD有明显差异(P<0.01和P<0.05).结论 颈动脉粥样硬化累及颈动脉窦可损害老年人自主神经功能调节.%Objective To investigate the relationship between heart rate variability and carotid atherosclerosis involved or not involved carotid sinus in the aged. Method 95 patients were divided into two groups according to whether there was carotid atherosclerosis or not( group of carotid atherosclerosis, and group of carotid non-atherosclerosis). Both groups accepted Holter examination. In control group,50 of patients aged 60-75 years old showed no abnormal findings in blood glucose and lipid laboratory examination,x ray chest,and cervical vessels color Doppler examination. In group of carotid atherosclerosis, totally 45 patients aged 62-83 and 31 of them with atherosclerotic plaque at carotid sinus. GE System Five Color Doppler Ultrasound scanner and three-channels Holter of model DMPv were used,parameters such as SDNN, SDANN, SDNNIndex,rMSS.D, and PNN50％ were obtained. Results SDNN and SDANN were significant lower in patients with carotid atherosclerosis plaque than those in patients without carotid atherosclerosis plaque (P ＜0.05 and P ＜ 0.01 ) ,and SDNN ,rMSSD in those with carotid sinus atherosclerosis were also significant lower than those without carotid sinus atherosclerosis. Conclusion There was autonomic nerve system injury in patients with carotid atherosclerosis involved sinus.
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