连续心率减速力对爆发性心肌炎患者预后的预测价值  

Heart Rate Deceleration Runs Predictive Value for The Prognosis of Patients with Fulminant Myocarditis

作　　者：甘文雪[1] 陈肖艺[1] GAN Wen-xue;CHEN Xiao-yi(Maoming people's hospital,Maoming 525000,Guangdong Province,China)

机构地区：[1]广东省茂名市人民医院心电图科,广东茂名525000

出　　处：《罕少疾病杂志》2023年第5期52-53,63,共3页Journal of Rare and Uncommon Diseases

摘　　要：目的探讨连续心率减速力(heart rate deceleration runs,DRs)对爆发性心肌炎患者预后的预测价值。方法选择爆发性心肌炎患者41例作为实验组,同期非心脏病患者40例作为对照组。在实验组中,根据心力衰竭程度及组织灌注情况分为无心衰组(BNP<400pg/mL)、轻度心衰组(BNP>400pg/mL,不伴周围组织灌注不足)、严重心衰组(BNP>400pg/mL,伴周围组织灌注不足)。根据心律失常发生情况分为恶性心律失常组、心律失常组(其他非恶性心律失常)及无心律失常组。应用动态心电图分析软件记录各组DRs值,同时根据常用指标DR2、DR4和DR8进行危险分层。观察各组DRs值之间的差异性及相关性。结果严重心衰组DRs显著低于轻度心衰组和无心衰组,轻度心衰组DRs显著低于无心衰组。恶性心律失常组DRs显著低于心律失常组和无心律失常组,心律失常组DRs显著低于无心律失常组。DRs低、中危组中心源性休克、急性心肌缺血、心脏骤停发生率显著低于高危组。且上述差异均有统计学意义。结论DRs检测可稳定评估爆发性心肌炎患者迷走神经功能,有望成为预测爆发性心肌炎患者预后的重要指标。Objective to investigate the prognostic value of continuous heart rate deceleration runs(DRS)in patients with fulminant myocarditis.Methods 41 patients with fulminant myocarditis were selected as experimental group and 40 patients without heart disease were selected as control group.In the experimental group,according to the degree of heart failure and tissue perfusion,they were divided into three groups:non-heart Failure Group(BNP<400pg/ml),mild heart failure group(BNP>400PG/ml,without peripheral tissue perfusion insufficiency),and severe heart failure group(BNP>400PG/ml,with peripheral tissue perfusion insufficiency).According to the occurrence of arrhythmia were divided into malignant arrhythmia group,arrhythmia group(other non-malignant arrhythmia)and non-arrhythmia group.Holter monitor software was used to record the DRS values for each group,and risk stratification was performed according to the commonly used markers DR2,DR4,and DR8.The difference and correlation of DRS values were observed.Results The DRS of severe heart failure group was significantly lower than that of mild heart failure group and no heart failure group,and the DRS of mild heart failure group was significantly lower than that of no heart failure group.DRS of malignant arrhythmia group was significantly lower than that of arrhythmia group and non-arrhythmia group,and DRS of arrhythmia group was significantly lower than that of non-arrhythmia group.The incidences of Cardiogenic shock,acute myocardial ischemia and cardiac arrest were significantly lower in the low-DRs and moderate-risk groups than in the high-risk group.And the above differences have statistical significance.Conclusion DRS can be used to evaluate the vagus nerve function in patients with fulminant myocarditis,and it may be an important index to predict the prognosis of fulminant myocarditis.

关 键 词：连续心率减速力 爆发性心肌炎 预测 

分 类 号：R542.21[医药卫生—心血管疾病]