窦性心律震荡对充血性心力衰竭患者中危险分层的应用价值  

The application value of heart rate turbulence in the risk stratification of patients with congestive heart failure

作　　者：莫凤兴[1] 

机构地区：[1]广东省东莞市桥头医院内二科,东莞市523523

出　　处：《护理实践与研究》2017年第21期8-11,共4页Nursing Practice and Research

摘　　要：目的:探讨窦性心律震荡对充血性心力衰竭患者中危险分层的应用价值。方法:2015年6月~2017年6月随机选取100例充血性心力衰竭患者(CHF组),其中轻度CHF组患者50例,中重度CHF组患者50例。另外选取100例心脏功能健康患者作为对照组。检测各组患者的动态心率震荡(TD)、震荡初始(TO)、震荡斜率(TS)、室性期前收缩前心率(HRvpc)、左室射血分数(LVEF)、左室舒张末径(LVEDD)、左室内径(LAD)、心率变异性时域(SDNN)以及B型脑钠肽(BNP)水平。分析各组不同参数间的变化规律以及相关性。结果:CHF组患者的LVEF、SDNN和TS水平低于对照组(P<0.05),LVEDD、LAD、BNP、TD、TO水平高于对照组(P<0.05),HRT2级别患者例数多于对照组(P<0.05)。此外,中重度CHF组患者相比于轻度CHF组患者,其TS水平显著降低,而TD、TO水平以及HRT2级别患者例数显著升高(P<0.05)。相关性分析结果表明,CHF组患者的TO水平与LVEF和SDNN水平呈负相关关系(P<0.05);TS水平与患者的HRvpc和BNP水平呈负相关关系(P<0.05),与SDNN水平呈正相关关系(P<0.05);TD水平与患者的各项影响因素均无显著相关性(P>0.05)。结论:窦性心律震荡可以准确有效地评价充血性心力衰竭患者中危险分层情况,具有良好的应用价值。Objective： To explore the application value of heart rate turbulence in the risk stratification of patients with congestive heart failure. Methods： A total of 100 patients with congestive heart failure（ group CHF） were randomly selected from June 2015 to June 2017,including 50 cases of mild CHF group and 50 cases of moderate and severe CHF group. Another 100 patients with cardiac function health problems were selected as the control group. The turbulence dynamics（ TD）,turbulence onset（ TO）,turbulence slope（ TS）,heart rate of ventricular premature contraction（ HRvpc）,left ventricular ejection fraction（ LVEF）,left ventricular end diastolic diameter（ LVEDD）,left atrium diameter（ LAD）,heart rate variability time domain（ SDNN） and type B natriuretic peptide（ BNP） level were tested of the two groups. The variation law correlation of different parameters was analyzed between the two groups.Results： The levels of LVEF,SDNN and TS in the CHF group were lower than those in the control group（ P 〈 0. 05）. The levels of LVEDD,LAD,BNP,TD and TO were higher than those in the control group（ P 〈 0. 05）. The number of patients with HRT2 grade was more than that in the control group（ P 〈0. 05）. In addition,the level of TS in patients with moderate and severe CHF was significantly lower than that in patients with mild CHF,while the levels of TD,TO and HRT2 patients were significantly increased（ P 〈 0. 05）. The results of correlation analysis showed that the level of TO were negatively correlated with the levels of LVEF and SDNN（ P 〈 0. 05）; the level of TS was negatively correlated with the levels of HRvpc and BNP（ P 〈 0. 05）,and positively correlated with the level of SDNN（ P 〈 0. 05）; the level of TD was not correlated with various influencing factors of patients（ P 〉 0. 05）. Conclusion： The heart rate turbulence can accurately and effectively evaluate the risk stratification in patients with congestive heart failure,and has good applic

关 键 词：充血性心力衰竭 窦性心率震荡 危险分层 

分 类 号：R541.61[医药卫生—心血管疾病]