| Ventricular premature beats is the most common arrhythmia in children, the identification between benign ventricular premature beats and malignant ventricular premature beats is helpful for the doctors determining the prognosis and choosing the best treatment. At present, the identification of the characteristics of ventricular premature beats mainly depends on Lown classification, in this method, if the grade is greater than or equal to grade 3, we consider the ventricular premature beats is malignant or pathological. This method is significant, but there are some disadvantages. At first, many researches have proved that the severity of ventricular premature beats is not directly proportional with the number of ventricular premature beats, but is proportional with the severity of original diseases, whether have the other arrhythmia except ventricular premature beats, whether have the abnormity of ST-T, and whether have the decrease of HRV. Lown classification doesn't consider these situations. Second, Lown classification can't determine the pathogen and prognosis of ventricular premature beats. Now, some researches point out that the occurrence of ventricular premature beats in the children who have no pathological heart disease have a relationship with the disfunction of cardiac autonomic nervous system. Compared the children who have benign or malignant ventricular premature beats with the normal children, some scholars consider that both benign and malignant ventricular premature beats can make the disfunction of cardiac autonomic nervous system. The benign premature beats may resort from the disorder of the function of cardiac autonomic nervous system, and the pathological premature beats means the varying degrees of injury of cardiac autonomic nervous system. Heart rate variability (HRV) reflects the regulative level of the cardiac autonomic nervous system and its physiological regulation system. Through the anlysis of HRV, we want to discuss the relationship between children's ventricular premature beats and heart rate variability, and hope provide a new method for the diagnosis, treatment and evaluating prognosis of ventricular premature beats.Objective: Through analysing the indexes of frequency domain (VLF, LF, HF) and time domain (SDNN, SDANN, RMSSD, PNN50), we want to discuss the relationship between children's ventricular premature beats and the function of the heart's autonomic nervous system.Method: In the outpatients and inpatients of the First Hospital of Jilin University in 2004-2008 who are found ventricular premature beats by Kangtai TLC3000A automatic 12 lead Holter analysis system, we take 900 cases of children who are not given any drug treatment as the group of ventricular premature beats, whose group is divided into L1-L2 group (548 cases) and L3-L5 group (352 cases) by the Lown classification, and take 500 cases randomly selected from children who are sure to be healthy by analysis of the Holter and being asked medical history, physical examination and laboratory tests as the control group. In L1-L2 group, there are 296 cases of male in which 0-3 year-old 93 cases, 4-7-year-old 96 cases, 8-15-year-old 107 cases,and 252 cases of female in which 0-3 year-old 75 cases, 4-7-year-old 87 cases, 8-15-year-old 90 cases;In L3-L5 group, there are 183 cases of male in which 0-3 year-old 54 cases, 4-7-year-old 72 cases, 8-15-year-old 57 cases,and 169 cases of female in which 0-3 year-old 50 cases, 4-7-year-old 96 cases, 8-15-year-old 93 cases; In the control group, there are 276 cases of male in which 0-3 year-old 87 cases, 4-7-year-old 96 cases, 8-15-year-old 93 cases,and 224 cases of female in which 0-3 year-old 74 cases, 4-7-year-old 68 cases, 8-15-year-old 82 cases. All of the above monitoring records are audited and edited by professional editors after being automatically analyzed by computer. We remove all ectopic pulses and pseudo-differential, and make an analysis on sinus bradycardia.Result: In this stydy, in the comparison of HRV between children with ventricular premature beats and normal children at different genders and ages, we discover the indexes of HRV in group (L1-L2 group) of benign ventricular premature beats are significantly lower than ones in group of normal children of the same sex at the corresponding age (P<0.05), and the indexes of HRV in group (L3-L5 group) of malignant ventricular premature beats are significantly lower than ones in group (L1-L2 group) of benign ventricular premature beats (P<0.05). In the comparison of HRV between male and female children who are normal at different ages, we discover the indexes of HRV in male group are higher than ones in female group (P<0.05). At last, in the comparison of all indexes of HRV in normal children with same gender, but different ages shows that there is significant difference (P<0.05). Whether male children or female children, HRV will gradually increase as the age grows.Conclusion: 1. All the indexes of HRV will significantly decline when benign ventricular premature beats occurrs, and the indexes of HRV will much more obviously decline when malignant ventricular premature beats occurrs. So there is a negative correlation between HRV and the severity of ventricular arrhythmia. 2. In children of all ages, the indexes of HRV in male children are higher than the ones in female children. 3. With age, heart rate variability will gradually increase, in children. |
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