心率变异性指标联合血清淀粉样蛋白A在病毒性心肌炎患儿预后中的价值  

Prognostic value of heart rate variability combined with serum amyloid A protein in children with viral myocarditis

作　　者：杨娜 张娟娟 刘慧 Yang Na;Zhang Juanjuan;Liu Hui(Department of Functional Examination,Zhangye Second People's Hospital,Zhangye City,Gansu Province,734000,China)

机构地区：[1]张掖市第二人民医院功能检查科,甘肃省张掖市734000

出　　处：《现代电生理学杂志》2025年第1期18-21,共4页Journal of Modern Electrophysiology

摘　　要：目的 探讨心率变异性联合血清淀粉样蛋白A(SAA)在病毒性心肌炎(VMC)患儿预后中的价值。方法 收集张掖市第二人民医院2021年2月至2024年2月收治的120例VMC患儿的临床资料进行回顾性分析,包括患儿的年龄、性别、体重、基础疾病、肌酸激酶、左室射血分数、心率变异性指标及血清淀粉样蛋白A (SAA)水平。以随访6个月的预后情况分为预后良好组和预后不良组。采用二元logistic回归分析预后不良组的影响因素,并绘制受试者工作特征(ROC)曲线评估心率变异性指标、SAA水平及两者联合对预后不良组的预测效能。结果 单因素分析结果显示:预后不良组的肌酸激酶、SAA高于预后良好组,NN间期标准差(SDNN)、NN间期均值标准差(SDANN)、低频功率(LF)、高频功率(HF)低于预后良好组(P<0.05)。二元logistic回归分析显示:低水平的SDNN、SDANN、LF、HF及高水平的SAA是影响VMC患儿预后不良的独立危险因素(P<0.05)。ROC曲线分析结果显示:SDNN、SDANN、LF、HF联合SAA水平预测VMC患儿预后不良的AUC为0.801(95%CI:0.908~1.000),敏感度为93.80%,特异度为92.30%。结论 低水平的SDNN、SDANN、LF、HF及高水平的SAA是预测VMC患儿预后不良的有效指标,且联合预测效能更高。Objective To explore the value of heart rate variability combined with serum amyloid A protein(SAA)in the prognosis of children with viral myocarditis(VMC).Methods The clinical data of 120 children with VMC admitted to Zhangye Second People's Hospital from February 2021 to February 2024 were retrospectively analyzed,including age,sex,body weight,underlying diseases,creatine kinase,left ventricular ejection fraction,heart rate variability and SAA level.After 6 months of follow-up,the patients were divided into good prognosis group and bad prognosis group.Binary logistic regression was used to analyze the influencing factors of poor prognosis,and receiver operating characteristic(ROC)curve was drawn to evaluate the predictive efficacy of heart rate variability index,SAA level and their combination in the poor prognosis group.Results The results of univariate analysis showed that creatine kinase and SAA in the poor prognosis group were higher than those in the good prognosis group,and standard deviation of NN intervals(SDNN),standard deviation of the average of NN intervals(SDANN),low frequency power(LF)and high frequency power(HF)were lower than those in the good prognosis group(P<0.05).Binary logistic regression analysis showed that low levels of SDNN,SDANN,LF,HF and high levels of SAA were independent risk factors for poor prognosis in children with VMC(P<0.05).ROC curve analysis results showed that the AUC of SDNN,SDANN,LF and HF combined with SAA to predict poor prognosis of VMC children was 0.801(95%CI:0.908-1.000),sensitivity was 93.80%, specificity was 92.30%. Conclusion Low levels of SDNN, SDANN, LF, HF and high levels of SAA are effective indicators for predicting poor prognosis in children with VMC, and the combined prediction efficiency is higher.

关 键 词：心肌炎 儿童 心电描记术 血清淀粉样蛋白A 预后 

分 类 号：R54[医药卫生—心血管疾病]