肺叶切除术后自主神经在房颤中的作用

要彤; 王春光; 何庚戌; 李方江; 刘俊堂; 李海英; 蔡宝松; 周峰; 张雁

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肺叶切除术后自主神经在房颤中的作用

临床研究 | 更新时间：2025-10-15

- 肺叶切除术后自主神经在房颤中的作用
- The role of autonomic competing mechanism in the trigger of atrial fibrillation after pumonary sugery
- 临床心电学杂志 2015年24卷第4期页码：285-289
- 作者机构：
  
  1. 河北北方学院第一附属医院
  2. 解放军第251医院胸心血管外科
  3. 解放军第251医院麻醉科
- 作者简介：
- 基金信息：
- DOI：
  中图分类号： R541.75;R655.3
- 纸质出版：2015
- 稿件说明：
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[1]要彤,王春光,何庚戌,李方江,刘俊堂,李海英,蔡宝松,周峰,张雁.肺叶切除术后自主神经在房颤中的作用[J].临床心电学杂志,2015,24(04):285-289.

Yao tong, Wang chunguang, He gengxu, et al. The role of autonomic competing mechanism in the trigger of atrial fibrillation after pumonary sugery[J]. 2015, 24(4): 285-289.
[1]要彤,王春光,何庚戌,李方江,刘俊堂,李海英,蔡宝松,周峰,张雁.肺叶切除术后自主神经在房颤中的作用[J].临床心电学杂志,2015,24(04):285-289. DOI：

Yao tong, Wang chunguang, He gengxu, et al. The role of autonomic competing mechanism in the trigger of atrial fibrillation after pumonary sugery[J]. 2015, 24(4): 285-289. DOI：

摘要

目的探讨自主神经在肺叶切除术后房颤发生中的作用。方法对281例60岁以上接受肺叶或全肺切除术的患者进行术后连续96h的动态心电图监测

对出现房颤患者在房颤发生前2h的心率变异性指标进行分析

并与同期性别、年龄相匹配未发生房颤患者相应时间段的心率变异性指标进行对比研究

分析交感神经张力与迷走神经张力在房颤发生前的变化。结果 281例肺切除患者术后有48例患者出现房颤

发生率17.1%;房颤组及对照组的病例基本资料无明显统计学差异

房颤组在房颤发生前2h反映迷走神经张力的指标SDNN、rMSSD、pNN50、HF明显增高

而反映交感/副交感神经平衡的指标LF/HF与对照组降低无统计学差异;而在房颤发生前5min SDNN、rMSSD、pNN50、HF明显增高

而LF/HF比值明显降低

表明迷走神经张力明显增高。结论肺叶切除术后的房颤发生前心率变异性存在明显增高的表现

肺叶切除术后交感神经张力明显增高的背景下迷走神经张力竞争性增高可能是导致房颤发生的重要机制。

Abstract

Objective This study was designed to evaluate autonomic nervous changes preceding atrial fibrillation after pulmonary surgery. Methods 96 h Holter was recorded in cosecutive 281 patients who received pulmonary surgery with age over 60 years

and 48 patients occured atrial fibrillation. 2h Holter recordings before the onset of atrial fibrillation was compared with corresponding data from 48 age- and gender- matched surgical controls without AF. Five- minute segement of heart rate variability were studied. Results There was a signifaicant trend for RR interval among patients with AF to be lower than controls(p=0.06)

where as SDNN、r MSSD、p NN50、HF were significantly higher in patients with AF

and LF/HF was significantly lower in patients with AF 5 minutes before the onset of AF

respectively. Conclusions In the period before the onset of postoperative AF

there was a significant increases in HRV during a time when heart rate also increase. The parasympathetic resurgence competing with increasing sympathetic activity may be the important mechanism for postoperative AF.

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references

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