Lorenz散点图分析乳腺癌患者心率变异性的价值  

The value of Lorenz scatter plot in analysis of heart rate variability in the patients with breast cancer

作　　者：苏比努尔·卡哈尔 张宝文 徐春明 祖艾热·加日拉 赛比拜·约麦尔 张雪妮 Subinur Kahar;Zhang baowen;Xu chunming;Zuairejiarila;Sebibai Yomair;Zhang xueni(Third Clinical Medical College of Xinjiang Medical University,Urumqi,830000,China;Xinjiang Medical University,Urumqi,830011,China;Functional Examination Division,Xinjiang Medical University Cancer Hospital,Urumqi,830000,China)

机构地区：[1]新疆医科大学第三临床医学院,830000 [2]新疆医科大学,830011 [3]新疆医科大学附属肿瘤医院,830000

出　　处：《临床心电学杂志》2024年第4期255-259,265,共6页Journal of Clinical Electrocardiology

基　　金：新疆医科大学大学生科研创新基金资助项目(编号:CX2021078)。

摘　　要：目的探究Lorenz散点图在乳腺癌患者心率变异性分析中的价值。方法纳入2020年至2023年我院首诊乳腺癌患者240例,依据TMN分期分为0~Ⅰ、Ⅱ~Ⅲ、Ⅳ期三组,分析其心率变异性各指标特点;对比散点图指标与SDNN的相关性;利用ROC曲线评估Lorenz散点图在乳腺癌患者心率变异性不同程度下降时的预测价值。结果心率变异性时域、频域、散点图指标在0~Ⅰ期、Ⅱ~Ⅲ期间差异无统计学意义(P>0.05),在0~Ⅰ期、Ⅱ~Ⅲ期与Ⅳ期间差异均有统计学意义。Lorenz散点图长轴L、短轴W及面积A与SDNN的相关系数分别为0.762、0.521、0.678(P<0.05,呈显著相关);L、W、A在HRV轻度降低时的ROC曲线下面积为0.789、0.731、0.759,最佳界值为6.95cm、1.125cm、6.63cm2;在HRV中度降低时ROC曲线下面积为0.886、0801、0.866,最佳界值为5.95cm、1.175cm、4.69cm2。结论Ⅳ期心率变异性较0~Ⅲ期下降明显;Lorenz散点图L、W、A与SDNN均有显著相关性;HRV轻中度下降时,L的预测价值均较W、A大,最佳界值分别为6.95cm、5.95cm。Objective To investigate the changes of heart rate variability in patients with different stages of breast cancer and the value of Lorenz scatter plot in the heart rate variability analysis.Methods A total of 240 breast cancer patients who were first diagnosed in our hospital from 2020 to 2023 were included and classified into three groups according the TMN staging as 0~Ⅰ,Ⅱ~Ⅲ,andⅣ.The three groups were retrospectively analyzed for changes in the time-domain indexes,frequency-domain indexes and the Lorenz scatter plot indexes;the correlations between scatter plot and SDNN were compared;the ROC curve was used to assess the value of Lorenz scatter plot in the analyse of HRV in breast cancer patients.Results The differences of the above indexes between 0~ⅠandⅡ~Ⅲhad not statiscial significance(P>0.05),but the differences of the above indexes between 0~Ⅰand stageⅣor betweenⅡ~Ⅲand IV all had statistically significant.The correlation coefficients between the Lorenz scatter plot indexes as L、W、A and SDNN were 0.762,0.521,0.678(P<0.05);that had statistically significant.The area under the ROC curve of the Lorenz scatter plot indexes as L,W,and A were 0.789,0.731,0.759 in the above patients when their HRV decreased mildly;and were 0.886,0.801,0.866 when their HRV decreased moderately.The optimal cut-off values of L,W,and A were 6.95cm,1.125cm,6.63cm~2 for predicting the HRV decreased mildly;and were5.95cm,1.175cm,4.69 cm~2 for predicting the HRV decreased moderately.Conclusions HRV decreased significantly in stageⅣbreast cancer patients compared with stage 0~Ⅰand stageⅡ~Ⅲ;Lorenz scatter plot indexes had significant correlation with SDNN;the Lorenz scatterplot index as L had greater predictive value than W and A in both mild and moderate decreases of HRV with breast cancer patients;and its optimal predictive boundaries were respectively 6.95cm and 5.95cm.

关 键 词：心率变异性 乳腺癌 LORENZ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]