摘要
目的 探讨冠状动脉粥样硬化性心脏病(冠心病)合并急性心力衰竭患者心率变异的表达与心功能及预后的相关性.方法 选择2020年1月至2022年1月于牡丹江心血管病医院收治的冠心病合并急性心力衰竭患者63例进行研究,作为病例组;另选取同期我院未合并冠心病的急性心力衰竭患者50例,作为急性心力衰竭组;并选取同期我院健康体检者50例作为对照组.根据未发生心脏不良事件为预后良好组(45例),发生心脏不良事件为预后不良组(18例);分析三组患者心率变异水平变化情况,并分析其与心功能及预后的关系.结果 病例组患者R-R间期标准差(SDNN)、相邻正常心动周期差值的均方根(rMSSD)、低频分量(LF)及高频分量(HF)水平显著低于急性心力衰竭组和对照组,LF/HF显著高于急性心力衰竭组和对照组,急性心力衰竭组患者SDNN、rMSSD、LF及HF水平显著低于对照组,LF/HF显著高于对照组患者(P＜0.05).NYHA心功能Ⅱ级患者SDNN、rMSSD、LF及HF水平显著高于心功能Ⅲ级、Ⅳ级患者,LF/HF显著低于心功能Ⅲ级、Ⅳ级患者,心功能Ⅲ级患者SDNN、rMSSD、LF及HF水平显著高于心功能Ⅳ级患者,LF/HF显著低于心功能Ⅳ级患者(P＜0.05).预后良好组SDNN、rMSSD、LF及HF水平显著高于预后不良组,LF/HF显著低于预后不良组(P＜0.05);Spearman相关系数分析显示,SDNN、rMSSD、LF及HF与冠心病合并急性心力衰竭患者的心功能及预后之间呈负相关,LF/HF与冠心病合并急性心力衰竭患者心功能及预后之间呈正相关(P＜0.05).结论 冠心病合并急性心力衰竭心率变异水平表达异常,且与心功能及预后之间关系密切,有望为冠心病合并急性心力衰竭的预防和治疗开辟新思路.
Abstract
Objective To investigate the expression of heart rate variability(HRV)and correlation among HRV,heart function and prognosis in patients with coronary heart disease(CHD)complicated by acute heart failure(AHF).Methods The patients with CHD complicated by AHF(n=63)were chosen into case group from Mudanjiang Hospital of Cardiovascular Diseases from Jan.2020 to Jan.2022.At the same time the patients with AHF only were chosen into AHF group(n=50)and healthy controls were chosen into control group(n=50).The patients were divided,according to occurrence of adverse cardiac events,into good prognosis group(n=45)and poor prognosis group(n=18).The changes of HRV were analyzed in all groups,and relationship among HRV,heart function and prognosis were analyzed.Results The levels of standard deviation of all normal RR interval(SDNN),root mean square of successive differences in RR interval(rMSSD),low-frequency component(LF)and high-frequency component(HF)were significantly lower,and LF/HF was significantly higher in case group than those in AHF group and control group.The levels of SDNN,rMSSD,LF and HF were significantly lower,and LF/HF was significantly higher in AHF group and control group(P＜0.05).The levels of SDNN,rMSSD,LF and HFwere significantly higher,and LF/HF was significantly lower in patients with grade Ⅱ of NYHA classification than those in patients with grades Ⅲ and Ⅳ.The levels of SDNN,rMSSD,LF and HFwere significantly higher,and LF/HF was significantly lower in patients with grade Ⅲ than those in patients with grade Ⅳ(P＜0.05).The levels of SDNN,rMSSD,LF and HFwere significantly higher,and LF/HF was significantly lower in good prognosis group than those in poor prognosis group(all P＜0.05).The results of Spearman correlation coefficient analysis showed that SDNN,rMSSD,LF and HF were negatively correlated to heart function and prognosis,and LF/HF was positively correlated to heart function and prognosis in patients with CHD complicated by AHF.Conclusion The expression of HRV was abnormal and closely related to heart function and prognosis in patients with CHD complicated by AHF,which opens a new way for the prevention and treatment of CHD complicated by AHF.
维普
万方数据