二维和三维心电散点图在HRV分析中的价值  

Diagnostic value of Lorenz scatter plotsand three-dimensional RR scatter plots in HRV analysis

作　　者：刘婷婷 马兰[1] 章富君 王云 Liu tingting;Ma lan;Zhang fujun;Wang yun(Department of electrocardiography,the Second Affiliated Hospital of Medical University Of Anhui,Hefei,230601,China;Department of Electrophysiology,Second Peopled Hospital of Chizhou City,Chizhou,247100,China)

机构地区：[1]安徽医科大学第二附属医院,230601 [2]安徽省池州市第二人民医院,247100

出　　处：《临床心电学杂志》2022年第2期92-97,共6页Journal of Clinical Electrocardiology

基　　金：2019年度安徽医科大学校科研基金(编号:2019xkj039)。

摘　　要：目的 探寻二维及三维心电散点图中对心率变异性(HRV)具有诊断价值的指标。方法 抽取行24小时动态心电图检查的患者641例,收集其时域指标SDNN、二维及三维心电散点图指标(L_(0)、W、L_(0)/W、L、L_(1)、L_(2))。根据SDNN值将患者分为3组(HRV正常组、HRV轻度减低组、HRV重度减低组)。运用统计学方法计算各指标与SDNN相关性,并绘制ROC曲线检验不同指标对HRV减低及其减低程度的诊断价值。结果(1)三组中,各指标均与SDNN具有相关性,其中“窦律点”图形长轴的相关指标(L_(0)、L、L_(1)、L_(2))与SDNN相关性最大;(2)心率变异性减低ROC曲线显示,二维心电散点图中L_(0)和三维心电散点图中L_(2)曲线下面积(AUC)最大,其最佳临界值分别为854.60ms和480.00ms;(3)心率变异性重度减低ROC曲线显示L_(0)的AUC为0.973,L_(2)的AUC为0.972,其最佳临界值分别为564.30ms和382.50ms。结论 二维及三维心电散点图中“窦律点”图形长轴对HRV诊断具有较强的诊断价值。Objective To explore the diagnostic value of Lorenz scatter plots and three-dimensional RR scatter plots in heart rate variability(HRV) analysis. Methods Selected 641 patients who underwent Holter monitor in our hospital, and collected the SDNN, Lorenz scatter plots and three-dimensional scatter plots indexes(L_(0), W, L_(0)/W, L,L_(1), L_(2)).According to the SDNN value, the patients were divided into three groups: normal HRV group, HRVslight decrease group and HRV severe decrease group. We calculated the correlation between all indexes and SDNN value and tested the diagnostic value of different indexes in the reduction of HRV and its reduced degree by ROC curves.Results(1)Among the three groups, all the indexes were correlated with SDNN, and the correlation between the long axis of "sinus rhythm point" pattern(L_(0), L, L_(1), L_(2)) and SDNN was the most significant;(2)ROC curve showed that the area under the curve(AUC) of L_(0)was the largest in the Lorenz scatter plots and the AUC of L_(2)in the three-dimensional scatter plots, and the best critical values were 854.60ms and 480.00ms;(3) The ROC curve of severe decreased HRV showed that the AUC of L_(0)was 0.973 and the AUC of L_(2)was 0.972, and the best critical values were 564.3ms and 382.5ms respectively. Conclusions The long axis of "sinus rhythm point" in Lorenz and three-dimensional scatter plots has a great diagnostic value in HRV.

关 键 词：心率变异性 LORENZ散点图 心电散点图 二维散点图 三维散点图 

分 类 号：R541.7[医药卫生—心血管疾病] R540.41[医药卫生—内科学]