心率变异性联合肺功能检测对慢性肺源性心脏病急性加重期患者预后的评估价值研究  

Prognostic value of heart rate variability combined with lung function te st in patients with acute exacerbation of chronic pulmonary heart disease

作　　者：黄雪 HUANG Xue(Department of Geriatric General,Mianyang Central Hospital,School of Me dicine,University of Electronic Science and Technology of China,Mianyang Sichuan 621000)

机构地区：[1]电子科技大学医学院附属绵阳医院,绵阳市中心医院老年综合科,四川绵阳621000

出　　处：《当代医药论丛》2023年第9期146-149,共4页

摘　　要：目的:探讨心率变异性(HRV)联合肺功能检测对慢性肺源性心脏病急性加重期(AECCP)患者预后的评估价值。方法:选取2020年6月至2022年5月绵阳市中心医院收治的AECCP患者125例为研究对象,根据住院期间的存活情况将其分为死亡组(n=24)与生存组(n=101)。比较两组的一般资料、HRV指标及肺功能指标,经Logistic回归分析AECCP患者预后的影响因素。结果:两组的性别、年龄、体质指数、慢性肺源性心脏病(CCP)病程、原发疾病、吸烟史、饮酒史比较,差异无统计学意义(P>0.05)。死亡组的低频和高频比值(LF/HF)、R-R间期标准差(SDNN)、5 min平均心率(SDANN)、第一秒用力呼气容积占用力肺活量的百分比(FEV_(1)/FVC)及FEV_(1)占预计值的百分比(FEVl%pred)均低于生存组,差异有统计学意义(P<0.05)。Logistic回归分析表明,LF/HF、SDANN、SDNN、FEV_(1)/FVC、FFEVl%pred降低均为AECCP患者死亡的独立危险因素(P<0.05)。结论:HRV、肺功能检测均能有效评估AECCP患者的预后情况,二者联合检测有望进一步提高预警价值。Objective:To evaluate the prognostic value of heart rate variability(HRV)combined with lung function test in patients with acute exacerbation of chronic pulmonary heart disease(AECCP).Methods:A total of 125 patients with AECCP admitted to Mianyang Central Hospital from June 2020 to May 2022 were selected as research objects.According to their survival during hospitalization,they were divided into death group(n=24)and survival group(n=101).The general data,HRV index and lung function index of the two groups were compared,and the influencing factors of prognosis of AECCP patients were analyzed by Logistic regression.Results:There were no significant differences in gender,age,body mass index,duration of chronic pulmonary heart disease(CCP),primary disease,smoking history and drinking history between the two groups(P>0.05).The ratio of low frequency to high frequency(LF/HF),the standard deviation of R-R interval(SDNN),the average heart rate of 5 min(SDANN),the percentage of forced expiratory volume in the first second to forced vital capacity(FEV_(1)/FVC)and the percentage of FEV_(1) to predicted value(FEVl%pred)in the death group were all lower than those in the survival group.The difference was statistically significant(P<0.05).Logistic regression analysis showed that LF/HF,SDANN,SDNN,FEV 1/FVC and FEVl%pred reduction were all independent risk factors for death in AECCP patients(P<0.05).Conclusion:Both HRV and lung function tests can effectively evaluate the prognosis of patients with AECCP,and their combined detection is expected to further improve the early war ning value.

关 键 词：慢性肺源性心脏病急性加重期 心率变异性 肺功能 预后 动态心电图 

分 类 号：R541.5[医药卫生—心血管疾病]