围产期心肌病患者心室重构、亚临床炎症和心率变异性的研究  

Study of ventricular reconstruction,subclinical inflammation and heart rate variability in patients with peripartum cardiomyopathy

作　　者：李晓吉 李晶[2] 

机构地区：[1]新疆乌鲁木齐市慈善医院妇产科,新疆乌鲁木齐830001 [2]新疆医科大学第一附属医院妇产科,新疆乌鲁木齐830054

出　　处：《中国妇幼健康研究》2014年第4期622-624,共3页Chinese Journal of Woman and Child Health Research

基　　金：新疆医科大学第一附属医院科研奖励基金资助项目(2009YFY-9)

摘　　要：目的探讨围产期心肌病(PPCM)患者心室结构和功能变化、心率变异性(HRV)和炎症因子的相互关系。方法研究对象为2007年6月至2012年6月收集的在新疆医科大学第一附属医院产科住院的PPCM患者30例作为PPCM组,选择同期住院分娩、年龄相匹配的30例正常孕妇为对照组。行24小时动态心电图检查,检测心率变异性时域指标(SDNN、RMSSD、SDANN和PNN50),同时检测PPCM超声心动图指标(心室内径、室间隔厚度和幅度)变化。结果 30例PPCM患者左心室内径、右心室内径、室间隔厚度、左心室后壁厚度均大于对照组(t值分别为4.256、3.636、2.012、2.003,均P<0.05),而室间隔幅度、左心室后壁幅度和LVEF低于对照组(t值分别为3.027、4.015、6.003,均P<0.05)。PPCM组SDNN、SDANN、RMSSD、PNN50均低于对照组,差异有统计学意义(t值分别为4.012、3.158、3.140、2.235,均P<0.05)。PPCM组hs-CRP值高于对照组,差异有统计学意义(t=2.303,P<0.05)。相关分析发现,hsCRP与SDNN,SDANN,RMSSD,PNN50呈负相关(r值分别为-0.568,-0.385,-0.328,-0.273,均P<0.05),与左心室内径和室间隔厚度呈正相关(r值分别为3.89、5.57,均P<0.05)。结论PPCM患者亚临床炎症、自主神经失衡和心室重构有关,随着hs-CRP水平升高,心室重构明显加重,时域指标明显下降。Objective To investigate the relationship among ventricular structure, function variation, heart rate variability （HRV） and inflammatory factors in patients with peripartum cardiomyopathy （PPCM）. Methods From June 2007 to June 2012 30 cases of PPCM were admitted in the First Affiliated Hospital of Xinjiang Medical University and were selected in PPCM group. Another 30 hospitalized cases of normal women with similar age were selected in control group. HRV indexes （SDNN, RMSSD, SDANN and PNN50 ） and ultrasound cardiogram indexes （ventricle diameter, interventrieular septal thickness and septal margin ） were detected by 24-hour dynamic electrocardiogram. Results The left ventrieular internal diameter, right ventricular internal diameter, interventricular septal thickness and left ventricular posterior wall thickness in PPCM group were significantly higher than those in the control group （ t value was 4. 256, 3. 636, 2. 012 and 2. 003, respectively, all P 〈 0.05 ） , but the margin of interventricular septum, left ventricular posterior wall and left ventricular ejection fraction （LVEF） were significantly decreased than those in the control group （t value was 3. 027, 4. 015 and 6. 003, respectively, all P 〈 0. 05）. The SDNN, SDANN, RMSSD and PNN50 in PPCM group were significantly decreased than those in the control group （t value was 4. 012, 3. 158, 3. 140 and 2. 235, respectively, all P 〈 0.05）. The high sensitivity C-reactive protein （hs-CRP） in PPCM group was significantly higher than that in the control group （ t = 2. 303, P 〈 0.05 ）. Correlation analysis showen that hs-CRP was negatively correlated with SDNN, SDANN, RMSSD and PNN50 （r value was -0. 568, - 0. 385, - 0. 328 and - O. 273, respectively, all P 〈 0.05 ）, but positively correlated with left ventricular inner diameter and thickness of the interventricular septum （ r value was 3.89 and 5.57, respectively, both P 〈 0.05 ）. Condusion Subclinical inflammation and autonomic nervous disturbances are co

关 键 词：围产期心肌病 心率变异性 时域分析 亚临床炎症 

分 类 号：R714.7[医药卫生—妇产科学]