摘要
目的探析冠心病患者诊断评估中其机体冠状病变严重程度与心率变异性存在的相关性。方法选取就诊且经冠状动脉造影确诊为冠心病患者70例,冠脉病变程度标准以Gensini评分加以判定后予以分组,划作轻度组(n=25例)、中度组(n=23例)及重度组(n=22例),行24h常规动态心电图监测三组心率变异性指标水平,涵盖相邻正常RR期间>50ms的心搏数占24h总RR间期数的百分比(PNN50)、相邻正常RR间期差值的均方根(r MSSD)、24h每5minRR间期平均值(SDANN)及24h正常RR间期的标准差(SDNN),并作比较分析。结果轻度组、中度组及重度组心率变异性指标中PNN50、r MSSD、SDANN及SDNN水平两两比较均有统计学差异,且呈低水平的心率变异性指标所对应的冠脉病变严重程度愈高(P<0.05);经多因素Logistic回归分析,心率变异性是冠脉病变朝严重程度进展的独立危险因素,且据Pearson相关性分析,PNN50、r MSSD、SDANN及SDNN水平与Gensini评分呈负相关。结论冠心病患者中运用心率变异性指标可较为准确评估冠脉病变,具有一定应用价值。
Objective To explore the correlation between severity of coronary artery disease and heart rate variability in the diagnosis and evaluation of patients with coronary heart disease.Methods 70 patients who came to this hospital for treatment were selected and were diagnosed with coronary heart disease by coronary angiography.The severity of coronary artery disease was judged by Gensini score,and then the patients were grouped into mild group(n=25),moderate group(n=23)and severe group(n=22).The heart rate variability indexes levels were monitored among the three groups by 24 h routine dynamic electrocardiogram,including percentage of heart beats>50 ms during the adjacent normal RR period in the total number of 24 h RR intervals(PNN50),root mean square of the difference between adjacent normal RR intervals(r MSSD),mean RR intervals per 5 min in 24 h(SDANN)and standard deviation of 24 h normal RR intervals(SDNN),and comparative analysis was performed.Results There were statistically significant differences in the heart rate variability indexes of PNN50,r MSSD,SDANN and SDNN among mild group,moderate group and severe group,and lower levels of heart rate variability indexes were associated with higher severity of coronary artery disease(P<0.05).After multivariate Logistic regression analysis,heart rate variability is an independent risk factor for the progression of severity of coronary artery disease.According to Pearson correlation analysis,PNN50,r MSSD,SDANN and SDNN were negatively correlated with Gensini score.Conclusion Heart rate variability indexes in patients with coronary heart disease can more accurately assess coronary artery disease and have certain application value.
作者
马宁
Ma Ning(Internal Medical-Cardiouascular Department,Sanmenxia Central Hospital,Sanmenxia472000,China)
出处
《哈尔滨医药》
2021年第6期4-5,共2页
Harbin Medical Journal
关键词
冠心病
心率变异性
冠脉病变
动态心电图
Coronary heart disease
Heart rate variability
Coronary artery disease
Dynamic electrocardiogram
