摘要
目的探讨心率变异性指标对慢性心力衰竭病情评估及预后的应用价值。方法选取2015年3月-2016年9月在本院住院治疗的慢性心衰患者共249例为研究对象,根据美国纽约心脏病学会(NYHA)心功能分级,将患者分为观察组(Ⅱ~Ⅲ级)和对照组(Ⅳ级)。选用世纪今科公司生产的动态心电检测系统,对两组患者的窦性心律进行24h连续自动分析,以HRV时域定量指标[心率总体标准差(SDNN)、全程每5分钟时间段RR间期平均值的标准差(SDANN)、心率差值均方的平均根(RMSSD)、三角指数]作为评价标准,以患者的风险事件发生情况作为预后指标。结果与对照组的SDNN(66.95±11.72)、SDANN(69.28±12.56)、RMSSD(14.37±3.94)、三角指数(11.79±5.44)相比,观察组的各项指标参数(71.92±16.59)、(75.32±14.23)、(17.10±6.38)、(14.39±7.32),均显著降低,差异均具有统计学意义(P<0.01)。与观察组NYHA分级Ⅲ级的指标参数SDNN(87.12±19.73)、SDANN(86.1±19.48)、RMSSD(19.42±8.36)、三角指数(16.04±9.32)相比,对照组NYHA分级Ⅱ级的SDNN(64.27±13.85)、SDANN(60.73±11.64)、RMSSD(15.03±4.28)、三角指数(10.95±4.46)显著低于Ⅲ级的指标参数,差异均具有统计学意义(P<0.01)。观察组窦性心律失常发生62例(53.9%),心脏病事件22例(19.1%),窦性心律失常伴心脏病事件13例(11.3%);对照组的窦性心律失常发生37例(27.6%),心脏病事件11例(8.2%),窦性心律失常伴心脏病事件6例(4.5%),观察组患者心血管风险事件发生例数明显高于对照组,差异均有统计学意义(P<0.05)。结论心率变异性的这一指标对评估慢性心衰患者病情的评价以及预后的评判具有重要的意义。
Objective To investigate the value of heart rate variability(HRV)on the evaluation and prognosis of chronic heart failure(CHF).Methods A total of 249 patients with chronic heart failure hospitalized in our hospital from March 2015 to September 2016 were enrolled.According to the classification of cardiac function of,the patients were divided into experimental group(gradeⅡ to gradeⅢ)and control group(gradeⅣ).Two groups of patients′sinus rhythm were automatic analysed for 24 hby the dynamic ECG detection system which made in century-times technology company.HRV time quantitative indexes(SDNN,SDANN,RMSSD,triangular index)were as the evaluation criteria,based on the patient′s risk events as a prognostic indicator.Results Compared with SDNN(66.95±11.72),SDANN(69.28±12.56),RMSSD(14.37±3.94),triangular index(11.79±5.44)in the control group,the parameters of the observation group were(71.92±16.59),(75.32 ±14.23),(17.10±6.38),(14.39±7.32),respectively,which were significantly decreased,and the difference was statistically significant(P <0.01).And the SDNN parameters were observed in group NYHA grade gradeⅢ(87.12±19.73),SDANN(86.1±19.48),RMSSD(19.42±8.36),triangular index(16.04±9.32)compared to the control group,NYHA gradeⅡ SDNN(64.27±13.85),SDANN(60.73±11.64),RMSSD(15.03±4.28),triangular index(10.95±4.46)index grade significantly lower,and the differences were statistically significant(P <0.01).In the observation group,there were 62 cases of sinus arrhythmia(53.9%),22 cases of heart disease events(19.1%),13 cases of sinus arrhythmia and cardiac events(11.3%);In the control group,there were37 cases of sinus arrhythmia(27.6%),11 cases of heart disease events(8.2%),6 cases of sinus arrhythmia with heart disease events(4.5%)The rate of heart disease event in observation group was significantly higher than the control group,and the differences were statistically significant(P <0.05).ConclusionThe index of heart rate variability is of great significance for evaluating the patient′s condition and judging the prognosis of the patients with chronic heart failure.
出处
《新疆医科大学学报》
CAS
2018年第3期291-294,共4页
Journal of Xinjiang Medical University
基金
安徽省科技攻关计划项目(1501041163)
关键词
慢性心力衰竭
心率变异性
心功能分级
chronic heart failure
heart rate variability
cardiac function classification
