初诊淋巴瘤患者的动态心电图分析  

Dynamic electrocardiogram analysis in untreated lymphoma patients

作　　者：王莉[1] 成思瑶 王妍 胡冀蒙 梁续飞[1] 刘海生[2] 郭庆娜 耿旭红[1] Wang Li;Cheng Siyao;Wang Yan;Hu Jimeng;Liang Xufei;Liu Haisheng;Guo Qingna;Geng Xuhong(Department of Function,The Fourth Hospital of Hebei Medical University,Shijiazhuang 050011,China;Department of Hematology,The Fourth Hospital of Hebei Medical University,Shijiazhuang 050011,China)

机构地区：[1]河北医科大学第四医院功能科,石家庄050011 [2]河北医科大学第四医院血液科,石家庄050011

出　　处：《中华心律失常学杂志》2023年第2期104-110,共7页Chinese Journal of Cardiac Arrhythmias

基　　金：河北省医学科学研究课题计划(20230854,20230833)。

摘　　要：目的对比淋巴瘤患者动态心电图和静息心电图的心电异常事件检出率,同时探讨初诊淋巴瘤患者的心率变异性特点。方法本研究为前瞻性研究,将2022年9月至12月于河北医科大学第四医院初次就诊的淋巴瘤患者作为淋巴瘤组,同一时期与淋巴瘤患者匹配的非肿瘤患者作为对照组,对两组患者心率变异性特征及淋巴瘤患者动态心电图及静息心电图结果进行分析,比较两组间心率变异性特征是否存在差异,对比淋巴瘤患者动态心电图和静息心电图心律失常事件的检出率。结果最终入选淋巴瘤组患者67例,年龄(57.7±12.4)岁,其中男39例(58.2%,39/67);对照组67例,年龄(57.2±12.4)岁,其中男38例(56.7%,38/67)。两组患者的基本信息包括性别、年龄、个人史、是否合并高血压、糖尿病、脑卒中及心血管用药等方面均差异无统计学意义(P>0.05)。淋巴瘤组中有3例(4.5%,3/67)霍奇金淋巴瘤患者,非霍奇金淋巴瘤64例(95.5%,64/67),其中,弥漫大B细胞淋巴瘤44例(65.7%,44/67)所占比例最大。Ⅳ期及Ⅱ期淋巴瘤患者居多,分别为25例(37.3%,25/67)、24例(35.8%,24/67)。频域分析中,淋巴瘤组患者极低频功率(VLF)低于对照组[628.90(318.30,1240.71)ms2对1124.30(731.10,1966.00)ms2,P<0.001];标准化低频功率(LFnorm)低于对照组[(52.52±14.64)nu对(58.99±13.06)nu,P=0.008];标准化高频功率(HFnorm)高于对照组[(47.48±14.64)nu对(41.01±13.06)nu,P=0.008];低频与高频功率之比(LF/HF)低于对照组[1.27(0.76,1.62)对1.54(1.00,2.20),P=0.010];时域分析中,淋巴瘤组患者24 h窦性RR间期标准差(SDNN)低于对照组[102.00(78.00,128.00)ms对128.00(107.00,151.00)ms,P<0.001];24 h内每个5 min时段窦性RR间期均值标准差(SDANN)低于对照组[(95.90±39.49)ms对(121.51±32.39)ms,P<0.001];三角指数低于对照组[25.93(19.53,31.78)对33.17(29.46,41.25),P<0.001];24 h内相邻RR间期相差>50 ms的心搏次数占所有总心搏次数的百分比(pNN50)高于对照�Objective To explore the characteristics of heart rate variability(HRV)in patients with untreated lymphoma,and compare the detection rate of abnormal electrocardiogram(ECG)changes in patients with lymphoma between dynamic ECG and resting ECG.Methods This was a prospective study conducted in the Fourth Hospital of Hebei Medical University.From September 2022 to December 2022,untreated lymphoma patients(lymphoma group)with available ECG data were included in this study.Non-cancer individuals(control group)were matched to the cases in a 1∶1 ratio by age,sex,and comorbidities.The HRV difference between cases and controls were analyzed.The detection rate of arrhythmia events on dynamic ECG and resting ECG in lymphoma patients was compared.Results Six-seven patients were included in each group.The average age of lymphoma group was(57.7±12.4)years old,and control group was(57.2±12.4)years old,respectively.There were 39(58.2%,39/67)males in lymphoma group and 38(56.7%,38/67)males in control group.There was no significant difference between cases and controls in baseline characteristics such as gender,age,personal history,cardiovascular medications and comorbidities(P>0.05).There were 3 cases of Hodgkin′s lymphoma(4.5%,3/67),and non-Hodgkin′s lymphoma accounted for majority of the cases(95.5%,64/67),of which diffuse large B-cell lymphoma accounted for the largest proportion(65.7%,44/67).There were 25(37.3%,25/67)and 24(35.8%,24/67)patients with stageⅣand stageⅡlymphoma,retrospectively.In frequency domain analysis,very low frequency(VLF)[628.90(318.30,1240.71)ms2 vs.1124.30(731.10,1966.00)ms2,P<0.001],normalized low-frequency power(LFnorm)[(52.52±14.64)nu vs(58.99±13.06)nu,P=0.008],and low frequency(LF)/high frequency(HF)[1.27(0.76,1.62)vs.1.54(1.00,2.20),P=0.010]in lymphoma group was significantly lower than that in control group.Compared with control group,HFnu in lymphoma group was significantly higher[(47.48±14.64)nu vs.(41.01±13.06)nu,P=0.008].In time domain analysis,standard deviation of all NN interv

关 键 词：淋巴瘤 心率变异性 自主神经功能障碍 动态心电图 

分 类 号：R733.1[医药卫生—肿瘤]