摘要
目的探讨心率变异性(HRV)指标与冠状动脉病变狭窄(冠脉狭窄)程度的相关性。方法纳入本院2015年12月至2017年12月收治的冠脉狭窄患者96例,均经冠状动脉造影确诊。根据冠状动脉病变评分(Gensini积分)标准分为轻度狭窄组(n=31)、中度狭窄组(n=33)、重度狭窄组(n=32)。所有患者均接受24 h动态心电图检查,比较三组HRV指标,包括平均正常R-R间期标准差(SDNN)、每5 min R-R间期均值标准差(SDANN)、正常相邻RR间期差值均方根(r MSSD)、正常相邻R-R间期差值大于50 ms的百分比(p NN50)和低频与高频功率比值(LF/HF)。采用Pearson线性相关分析,明确HRV与冠脉狭窄程度(即Gensini积分)间的相关性。结果轻度狭窄组的SDNN、SDANN、r MSSD、p NN50高于中、重度狭窄组,且中度狭窄组各指标高于重度狭窄组,差异均有统计学意义(P<0.05)。轻度狭窄组的LF/HF、Gensini积分低于中、重度狭窄组,中度狭窄组上述指标低于重度狭窄组,差异均有统计学意义(P<0.05)。经Pearson线性相关分析发现SDNN、SDANN、r MSSD、p NN50与Gensini积分呈负相关(r值分别为-0.890,-0.877,-0.843和-0.802;P<0.05),LF/HF与Gensini积分呈正相关(r=0.872,P<0.05)。结论不同冠脉狭窄程度患者的HRV指标存在差异:冠脉狭窄程度越重,SDNN、SDANN、r MSSD、p NN50越低,LF/HF越高,反之亦然。HRV各指标均与冠脉狭窄程度有较强的相关性。
Objective To investigate the correlation between heart rate variability（ HRV） indexes and coronary artery stenosis.Methods Ninety-six patients specifically diagnosed with coronary artery stenosis by coronary angiography were enrolled in this study.They had been admitted to our hospital from December 2015 to December 2017.According to the grading system of coronary artery stenosis（ Gensini score）,they were divided into mild stenosis group（ 31 cases）,moderate stenosis group（ 33 cases） and severe stenosis group（ 32 cases）.All patients underwent 24-hour ambulatory electrocardiography examination.We compared the HRV indexes among the 3 groups,including standard deviation of NN intervals（ SDNN）,standard deviation of all 5-min averaged intervals（ SDANN）,root mean square of successive differences in RR interval（ r MSSD）,percentage of RR intervals differing more than50 ms from the preceding one（ p NN50）,and the ratio of low frequency to high frequency（ LF/HF）.Pearson linear correlation analysis was used to reveal the correlation between HRV and the severity of coronary artery stenosis（ Gensini score）.Results SDNN,SDANN,r MSSD and p NN50 of mild stenosis group were higher than those of moderate and severe stenosis groups while these indexes of moderate stenosis group were higher than those of severe stenosis group,all with statistically significant differences（ P 0.05）.The LF/HF and Gensini scores of mild stenosis group were lower than those of moderate and severe stenosis groups while these indexes of moderate stenosis group were lower than those of severe stenosis group,all with statistically significant differences（ P 0.05）.Pearson linear correlation analysis revealed that SDNN,SDANN,r MSSD and p NN50 were negatively correlated with Gensini score（ r =-0.890,-0.877,-0.843 and-0.802; P 0.05）.There was a positive correlation between LF/HF and Gensini score（ r = 0.872,P 0.05）.Conclusion HRV indexes were different among the patients with varied severity of coronary artery stenosis.The more severe the coronary stenosis,the lower were SDNN,SDANN,r MSSD and p NN50,and the higher was LF/HF,and vice versa.HRV indexes were strongly correlated with the degree of coronary stenosis.
作者
叶白茹
吴汉鑫
邹淑琴
Ye Bai-ru;Wu Han-xin;Zou Shu-qin(Department of Electrocardiogram,Fengshun County People＇s Hospital,Meizhou Guangdong 514329,China)
出处
《实用心电学杂志》
2018年第4期261-265,共5页
Journal of Practical Electrocardiology
