克州地区肺动脉高压致右心衰患者心率变异性与BNP的相关性  

Relationship between heart rate variability induced by pulmonary hypertension and B type natriuretic peptide in right heart failure patients in Kezhou area

作　　者：曲晨[1,2] 曹喆[3,4] 姚诚 李延超 张敏 陈林 司玉霞 谭晓[4,5] QU Chen CAO Zhe YAO Cheng LI Yanchao ZHANG Min CHEN Lin SI Yuxia TAN Xiao(Department of Geri- atrics, Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, China Emergency Center, Kizilsu Kirghiz Autono- mous Prefecture People＇s Hospital S Department of Cardiovascular Diseases, Second Affiliated Hospital of Nanfing Medical Universit Department of Cardiovascular Diseases, Kizilsu Kirghiz Autonomous Prefecture People＇ s Hospital Emergency Center, Second Affiliated Hospital of Nanjing Medical University)

机构地区：[1]南京医科大学第二附属医院老年医学科,南京210011 [2]新疆克州人民医院急诊中心 [3]南京医科大学第二附属医院心血管科 [4]新疆克州人民医院心血管科 [5]南京医科大学第二附属医院急诊中心

出　　处：《山西医科大学学报》2016年第9期790-794,共5页Journal of Shanxi Medical University

基　　金：国家自然科学基金青年项目(81501202)

摘　　要：目的探讨克州地区肺动脉高压致右心衰患者心率变异性与B型尿钠肽(BNP)的相关性。方法选取在新疆克州人民医院急诊科接受治疗的42例肺动脉高压患者作为研究对象,选正常肺动脉压力的健康体检者11例作为对照,对所有患者进行超声心动图检查并同时做动态心电图检查,对比分析检查结果情况。结果重度肺动脉高压患者的相邻正常RR间期标准差(SDNN)、每5 min节段R-R间期平均值的标准差(SDANN)、每5 min节段R-R标准差的平均值(SDNNind)、相邻R-R间期差的均方根(r MSSD)、相邻R-R间期的差值超过50 ms的心搏数占监测心搏数的百分比(PNN50)含量明显低于正常肺动脉压力的患者,差异有统计学意义(P<0.05)。BNP检测结果与心率变异性联合检测敏感性、特异性为95.24%,97.62%,与BNP及心率变异性单独检测(59.52%,64.29%及64.29%,61.90%)相比较高,差异有统计学意义(P<0.05)。结论分析心率变异性与BNP的相关性能够作为辅助诊断肺动脉高压致右心衰的有效手段,具有重要的临床意义。Objective To explore the relationship between heart rate variability induced by pulmonary hypertension and B type natriuretic peptide（ BNP） in right heart failure patients in Kezhou area. Methods Forty-two patients with pulmonary hypertension and eleven patients with normal pulmonary artery pressure in Kizilsu Kirghiz Autonomous Prefecture People＇s Hospital were included in the study. All patients received echocardiographic and dynamic electrocardiogram examination at the same time. The results were compared and analyzed. Results Values of standard deviation for the time between normal-to-normal complexes in the entire 24 h electrocardiographic recording（ SDNN）,SD of the average normal-to-normal intervals for each 5 min period（ SDANN）,standard deviation average of NN intervals index（ SDNNind）,root mean square of difference of successive RR intervals（ r MSSD） and percent of adjacent RR intervals 50 ms apart（ PNN50） of patients with severe pulmonary hypertension were significantly lower than those of patients with normal pulmonary artery pressure（ P〈0. 05）. Sensitivity and specificity of BNP combined with heart rate variability were 95. 24% and 97. 62%,which were significantly higher than those of single detection of BNP or heart rate variability（ 59. 52%,64. 29% and 64. 29%,61. 90%,P〈0. 05）. Conclusion Correlation between heart rate variability and BNP can be used as an effective means to assist in the diagnosis of right heart failure induced by pulmonary hypertension,which is of important clinical significance.

关 键 词：肺动脉高压 右心衰 心率变异性 B型钠尿肽(BNP) 克州地区 

分 类 号：R543.5[医药卫生—心血管疾病]