老年动脉粥样硬化患者巨细胞病毒感染及心率变异性的相关性研究  

Relationship between cytomegalovirus infection and heart rate variability in elderly patients with atherosclerosis

作　　者：刘文捷[1] 周艺军[1] 周婵娟[1] 吴玉英[1] 郭志军[1] 

机构地区：[1]福建医科大学附属泉州第一医院老年科,362000

出　　处：《中华老年医学杂志》2014年第12期1279-1281,共3页Chinese Journal of Geriatrics

摘　　要：目的探讨老年动脉粥样硬化患者巨细胞病毒感染及心率变异性的相关性。方法选取冠心病患者160例，均符合世界卫生组织1979年冠心病诊断标准。根据人巨细胞病毒（HCMV）-PP65抗原检查结果分为阳性组（观察组）103例和阴性组（对照组）57例，对两组患者心率变异水平进行检测，同时检测其金属蛋白酶-9（MMP-9）和肿瘤坏死因子（TNF-α）水平，判断患者斑块的稳定性。结果观察组患者全部窦性心搏RR间期标准差（SDNN）、RR间期平均值标准差（SDANNI）、RR间期标准差平均值（SDNNI）均明显低于对照组，两组差异有统计学意义（P〈0．05）；两组患者相邻RR间期差值的均方根（RMSSD）水平、相邻NN之差（PNN50）比较，差异无统计学意义（P〉0．05）；观察组总胆固醇和低密度脂蛋白胆固醇水平明显高于对照组（P〈0．05），MMP-9和TNF-α水平低于对照组（P〈0．05）；观察组与对照组比较，斑块稳定率分别为20．4％（21／103）比61．4％（35／57），差异有统计学意义（χ^2=4．273，P=0．015）。结论伴有巨细胞病毒感染的动脉粥样硬化患者存在着较大的心率变异性，且其粥样斑块稳定性较差。Objective To investigate the correlation between cytomegalovirus infection and heart rate variability （HRV） in elderly patients with atherosclerosis. Methods 160 patients with coronary heart disease who met World Health Organization diagnostic criteria for coronary heart disease in 1979 were collected. According to the IMTHCMV-PP65 antigen test results, patients were divided into positive group （observation group, n= 103） and negative group （control group, n=57）. We detected the levels of of HRV, metalloprotease-9 （MMP 9） and tumor necrosis facto-α （TNF-α） in the two groups in order to access the plaque stability. Results The all sinus standard deviation of RR interval （SDNN）, standard deviation of the average NN interval （SDANNI）, mean value of sinus standard deviation of RR interval （SDNNI） were lower in observation group than in control group （P d0.05）. There were no significant differences in square root of the mean squared differences of successive NN intervals （RMSSD） level and percentage of differences exceeding 50ms between adjacent normal number of intervals （PNN50） between the two groups （P〉0.05）. The levels of total cholesterol and low density lipoprotein were higher and the levels of MMP-9 AND TNF-α were lower in observation group than in the control group （all P〈0.05）. Compared with control group, the plaque stability was decreased in observation group [20.4% （21/103） w 61.4% （35/57）χ^2 = 4. 273, P= 0. 015]. Conclusions Patients with atherosclerosis combined with cytomegalovirus infection have a greater heart rate variability and poorer plaque stability.

关 键 词：动脉粥样硬化 巨细胞病毒感染 心率 

分 类 号：R543.5[医药卫生—心血管疾病]