摘要
目的 回顾性分析窦性心率震荡现象（HRT）对慢性心功能衰竭患者预后的影响。方法 选择2000年1月～2005年1月的慢性心功能衰竭患者250例，其中在24h动态心电图（Holter）上能记录到室性期前收缩，且能随访到的有126例。将此126例患者分为死亡组（41例）和存活组（85例），记录各组病例可能影响预后的相关指标，包括年龄、性别、吸烟、高血压、血脂异常、糖尿病、家族史、尿酸升高、器质性心脏病种类、心衰发生的时间、左室射血分数（均采用面积长轴法）、心衰的用药（ACEI、Aspirin、Statin、β—Blockor等）以及HRT分类。HRTO为窦性心率震荡初始（TO）〈0并且窦性心率震荡斜率（TS）〉2．5ms／RRI（RR Interval）；HRT1为TO≥0或者TS≤2．5ms／RRI；HRT2为T0≥0并且TS≤2．5ms/RRI。统计学方法采用Logistic回归及χ^2检验。结果 126例患者平均随访（21．0±13.5）个月，共死亡41例。Logistic多元回归分析显示慢性心功能衰竭死亡与HRT分类、心衰发生的时间、高龄（≥70岁）显著相关，其危险度相关系数分别为42.618（P〈0．001）、39．657（P〈0．001）及10．320（P〈0.05）。结论 窦性心率震荡现象是慢性心功能衰竭死亡率良好的预测指标。
Objective We retrospectively analyse the significance of heart rate turbulence as a predictor of mortality after Chronic Heart Failure. Methods Two hundred and fifty patients with CHF were enrolled since January in 2000 to January in 2005. Among them one hundred and tenwty -six cases were divided into two groups, one was death and another was alives. Some risk factors may be influence mortality after CHF, such as age, sex, smoking, hypertension, diabetes mellitus, abnormal cholesterol, family history, high uric acid, the type of heart disease, method of therapy, drugs （such as Aspirin, Angiotensin Conversion Enzyme Inhibitor, Statins, and β- Blockor et al. ） after CHF, category of Heart Rate Turbulence （HRT）. HRT category 0 means turbulence onset （TO） 〈0 and turbulence slope （TS） 〉2. 5 ms/RRI, HRT category 1 means TO≥0 or TS ≤2. 5 ms/RRI, HRT category 2 means TO≥0 and TS≤2.5 ms/RRI. Results One hundred and twenty - six cases were involved, during a follow - up of 21.0 ± 13.5 months, forty - one patients died. On logistic multivariate analysis, HRT category 2, beginning- time of CHF and age ≥70y were the most significant predictors of death. The hazard ratio subsequently were 42.618 （P〈0. 001）, 39.657 （P〈0. 001） and 10. 320 （P 〈0.05）. Conclusion HRT is a strong predictor of subsequent death in CHF patients.
出处
《中国全科医学》
CAS
CSCD
2006年第6期453-455,共3页
Chinese General Practice
