老年HFpEF患者HRV及CysC的相关性分析  

Correlation analysis of HRV and CysC in elderly patients with HFpEF

作　　者：许波[1] 蒲世军[1] 蒲国俭[1] 杨军[1] 沈媚嘉[1] XU Bo;PU Shijun;PU Guojian;YANG Jun;SHEN Meijia(Department of Cardiology,Langzhong People′s Hospital,Nanchong,Sichuan 637000,China)

机构地区：[1]阆中市人民医院心内科,四川南充637000

出　　处：《现代医药卫生》2020年第13期1973-1976,共4页Journal of Modern Medicine & Health

摘　　要：目的探讨老年左心室射血分数保留性心力衰竭(HFpEF)患者心率变异性(HRV)及血清胱抑素C(CysC)的相关性,为HFpEF的诊断提供参考依据。方法选取2014年1月至2017年5月在该科住院的98例老年慢性心力衰竭(CHF)患者作为心力衰竭组,并根据美国纽约心脏协会(NYHA)心功能分级分为心功能Ⅱ级组(n=33)、Ⅲ级组(n=33)和Ⅳ级组(n=32)。选取同期住院的41例无心力衰竭老年患者作为对照组。完善动态心电图及CysC等相关检查。结果心力衰竭组患者尿酸、CysC水平均高于对照组,而正常RR间期标准差(SDNN)、5 min均值标准差(SDANN)、全程相邻RR间期之差的平方根(RMSSD)、相邻RR间期相差大于50 ms的个数占总心跳数的百分比(PNN50)均低于对照组,差异均有统计学意义(P<0.05);随着心功能的减退,SDNN、SDANN、RMSSD、PNN50均逐渐减少或降低,而CysC水平逐渐升高。CysC与SDNN、SDANN、RMSSD、PNN50均呈负相关(r=-0.66、-0.68、-0.59、-0.54,P<0.01)。结论CysC与HRV的相关指标均能反映心力衰竭程度,随着心力衰竭程度的加重,CysC水平逐渐升高,而HRV的相关指标逐渐减少或降低,CysC与HRV相关指标呈负相关。Objective To investigate the correlation between heart rate variability(HRV)and serum cystatin C(CysC)in elderly patients with left ventricular ejection fraction preserved conservative heart failure(HFpEF),and to provide reference for the diagnosis of HFpEF.Methods A total of 98 elderly patients with chronic heart failure(CHF)admitted to the department from January 2014 to May 2017 were selected as the CHF group.According to the New York Heart Association(NYHA)cardiac function class divided into cardiac functionⅡlevel group(n=33),Ⅲlevel group(n=33),Ⅳlevel group(n=32).A total of 41 cases without elderly patients were heart failure selected as control group at the same time.All patients should complete dynamic electrocardiogram and CysC examination.Results The uric acid,standard deviation of normal RR interval(SDNN),5 min mean standard deviation(SDANN),the square root of the difference between all adjacent RR intervals(RMSSD),the percentage of the total heart rate when the difference between adjacent RR intervals was greater than 50 ms(PNN50)and CysC level in CHF group were higher than those in the control group.The differences were statistically significant(P<0.05).With the decrease of cardiac function,SDNN,SDANN,RMSSD and PNN50 were gradually decreased,CysC was gradually increased.CysC was negatively correlated with SDNN,SDANN,RMSSD and PNN50(r=-0.66,-0.68,-0.59,-0.54,P<0.01).Conclusion The related indicators of CysC and HRV can reflect heart failure,and as the heart failure aggravates,the level are gradully increased CysC,the relevant indicators of HRV are gradually decreased,and the related indicators of CysC and HRV are negatively correlated.

关 键 词：左心室射血分数 心力衰竭 心率变异性 血清胱抑素C 老年人 

分 类 号：R446.1[医药卫生—诊断学] R445.1[医药卫生—临床医学]