冠状动脉病变与心率变异性关系的探讨  

The relationship between coronary artery lesion and heart rate variability

作　　者：张文静[1] 刘艳军[1] 王蔓莉[1] 赵佩[1] 葛庆锋[1] 李海涛[1] 

机构地区：[1]河北联合大学附属医院心内科,063000

出　　处：《临床心电学杂志》2014年第4期274-277,共4页Journal of Clinical Electrocardiology

摘　　要：目的研究冠状动脉病变支数、狭窄程度及病变部位与HRV之间的关系。方法选择同期行24h动态心电图及冠状动脉造影的患者143例,获取时域分析指标:SDNN、SDANNI、SDNNI、RMSSD、PNN50;依据冠状动脉造影结果,分为非冠心病组、冠心病组,冠心病组依据病变支数分为单支病变组、多支病变组,依据病变部位分为前降支为主组、左回旋支为主组、右冠脉为主组,所有患者依据Gensini评分分为A组、B组、C组、D组。采用SPSS17.0统计分析软件进行数据分析。结果 1随着冠状动脉病变支数的增加,HRV的指标SDNN、SDANNI、SDNNI、RMSSD、PNN50均显著降低(p<0.05);2冠状动脉不同病变部位患者之间的HRV无差异(p>0.05);3随着Gensini积分的增加,SDNN、SDANNI、SDNNI显著降低(p<0.05),RMSSD、PNN50虽有所下降,但差异无统计学意义(p>0.05)。结论冠心病患者的HRV显著降低,且与冠状动脉病变支数及狭窄程度呈负相关,但与冠状动脉病变部位无关,HRV对冠心病患者的病情评估具有一定的临床价值。Objective To investigate the relationship between coronary artery lesion counts,narrow degree,the lesion site and HRV.Methods We selected 143 patients who received 24 hours dynamic electrocardiogram examination and selective coronary angiography （CAG） in the same period,obtained the time domain analysis indicators：SDNN,SDANNI,SDNNI,RMSSD,PNN50; According to the results of CAG,the patients were divided into non-coronary heart disease group and coronary heart disease （CHD） group,according to lesion counts,the patients of CHD group divided into single lesion group and multi lesions group,according to the mainly pathological changes,the patients of CHD group divided into the left anterior descending group,the left circumflex branch group and the right coronary group,all of the patients on the basis of Gensini score were divided into group A and group B,C,D.Statistical analyses were performed using the SPSS 17.0.Results ①With the increase of coronary artery lesion counts,HRV indices SDNN,SDANNI,SDNNI,RMSSD,PNN50 were significantly lower （p〈0.05）; ②There was no difference in HRV between patients with different pathological changes; ③With the increase of Gensini score,SDNN,SDANNI,SDNNI significantly reduced （p〈0.05）,RMSSD,PNN50 was decreased,but there was no statistically significant difference （p〉0.05）.Conclusions The HRV decreases significantly in patients with coronary heart disease,and it is inversely associated with coronary artery lesion counts and the degree of stenosis,but has nothing to do with pathological changes of coronary artery,the HRV can provide certain clinical value in patients with coronary heart disease.

关 键 词：冠状动脉病变 心率变异性 冠状动脉造影 

分 类 号：R541.4[医药卫生—心血管疾病]