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心率变异性(HRV)是指人体窦性心律时心率的变化,即RR间期的长短变化。人体窦性心律的心跳快慢主要决定于窦房结固有心率的高低以及窦房结之外的自主神经等对其频率的调节作用。其中交感神经使窦率提高,窦率值变化缩小,HRV值较低。相反,迷走神经使窦率降低,窦率值变化加大,HRV值升高,进而降低心脏性猝死及心血管不良事件的发生率。研究表明,在不同的生理条件下,在不同的疾病状态下,HRV可以有较大的变化。而HRV值的明显降低,有提示发生心脏性猝死的预警作用,进而成为临床预防猝死的一项重要无创心电检测指标。与所有的临床检查一样,HRV的检测也有一些特殊的人群,有其检查的适应证,当毫无任何节制任意给每个人都进行HRV检测时,将越过科学的界限,属于过度应用这项检查,不仅浪费了医疗资源,还可能给患者带来不良影响。本刊这次组织HRV的专题笔谈就是希望能澄清认识,既充分重视HRV的重要价值,又能减少过度应用。
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