慢阻肺患者的心率变异性临床分析  

Clinical analysis of heart rate variability in patients with chronic obstructive pulmonary disease

作　　者：朱代峰[1] 钱晓君[1] 张雪[1] 赵世光 荣光生 ZHU Dai-feng;QIAN Xiao-jun;ZHANG Xue;ZHAO Shi-guang;RONG Guang-sheng(Respiratory Department,the Third People’s Hospital of Hefei,Hefei,Anhui　230022,China)

机构地区：[1]安徽医科大学附属合肥第三临床学院,合肥市第三人民医院呼吸内科,安徽合肥230022

出　　处：《临床肺科杂志》2018年第5期797-801,共5页Journal of Clinical Pulmonary Medicine

基　　金：合肥市医学重点专科建设计划资助(NO.[2016]256)

摘　　要：目的探讨慢性阻塞性肺疾病(慢阻肺)患者的心率变异性(HRV)与其相关临床特征的关系。方法将56例慢阻肺病患者按FEV_1/预计值%、CAT评分、年急性加重次数、肺动脉压及综合评分进行分组;比较各亚组患者SDNN值差异,并分析SDNN值与各项临床资料的关系。结果 CAT评分<10分、FEV_1/预计值%≥50%及肺动脉压<40mm Hg者心率变异性指标SDNN值分别显著高于CAT≥10分、FEV_1/预计值%<50%及肺动脉压≥40mm Hg者;综合评估后D组患者的心率变异性明显下降(P<0.05);Pearson相关性分析结果显示,慢阻肺疾病患者心率变异性指标SDNN与患者CAT分值、年急性加重次数、分组、肺动脉压、颈椎病均相关;通过多元线性回归分析显示慢阻肺患者的肺动脉压力、颈椎病病史、年急性加重次数是SDNN的独立预测因素。结论慢阻肺病患者心率变异性异常下降与患者病情严重程度相一致,与肺动脉压、急性加重次数相关;可用于其病情严重程度及预后的评估。Objective To explore the relationships among heart rate variability and clinical characteristics of patients with chronic obstructive pulmonary disease.Methods 56 patients with chronic obstructive pulmonary disease were divided into different groups according to FEV 1/expected%,CAT score,the number of exacerbations within the previous 12 months,pulmonary artery pressure and comprehensive score.The differences of SDNN values between the subgroups were analyzed,and the relationship between the SDNN values and the clinical data was analyzed.Results The SDNN values of patients with CAT score<10 points,FEV 1/expected%≥50%and pulmonary artery pressure<40mmHg were significantly higher than that with CAT≥10 points,FEV 1/expected value of<50%and pulmonary artery pressure≥40mmHg,respectively.After comprehensive assessment,it found that the heart rate variability of patients in the group D was significantly decreased(P<0.05).Pearson correlation analysis showed that SDNN values of heart rate variability in patients with chronic obstructive pulmonary disease were correlated with CAT score,the number of exacerbations within the previous 12 months,comprehensive grouping,pulmonary artery pressure and history of cervical spondylosis.Multivariate linear regression analysis showed that pulmonary arterial pressure,history of cervical spondylosis and the number of exacerbations within the previous 12 months were independent predictors of SDNN.Conclusion The decrease in heart rate variability of patients with chronic obstructive pulmonary disease is consistent with the severity of the disease and associated with pulmonary arterial pressure and the number of exacerbations within the previous 12 months,and it is useful for assessing the severity and prognosis of patients with chronic obstructive pulmonary disease.

关 键 词：慢性阻塞性肺病 心率变异性 肺动脉压力 肺功能 

分 类 号：R563.9[医药卫生—呼吸系统]