心率变异性在散点图指标和时域指标中的对比分析
|
摘要
目的:探讨冠心病患者心率变异性(HRV)Lorenz-RR间期散点图指标和时域指标之间的相关性,比较两组指标对HRV异常的检出率。方法:对80例冠心病患者(冠心病组)与80例正常健康体检者(对照组)行24h动态心电图检查,对HRV Lorenz-RR间期散点图指标和时域指标进行对比分析;比较两组HRV指标对HRV异常的检出率。结果:与对照组比较,冠心病组的时域指标SDNN、SDANN及Lorenz-RR散点图指标长度(L)均显著下降,两组之间存在显著差异(均P<0.001)。在对照组与冠心病组,Lorenz-RR间期散点图长度L与SDNN、SDANN均呈显著正相关(均P<0.001),Lorenz-RR间期散点图宽度(W)与rMSSD、PNN50均呈显著正相关(均P<0.001)。Lorenz-RR间期散点图HRV异常检出率为90%,明显高于SDNN的63.75%(P<0.001)。结论:Lorenz-RR间期散点图指标较时域指标更能体现HRV的功能,可为临床提供可靠诊断依据。
Objective:To determine the value and relationship between Lorenz plot and time domain index of the heart rate variability(HRV)in patients with coronary heart disease(CHD).Method:Eighty patients with CHD(CHD group)and 80 healthy controls(control group)were involved in the study.All subjects were examined by 24-hour ambulatory electrocardiogram,and HRV Lorenz-RR interval scatter plot indexes and time domain indexes were compared,and the detection rate of HRV abnormality between the two groups was compared.Result:Compared with those in the control group,SDNN,SDANN and scattergram length(L)in the CHD group were significantly decreased(all P<0.001).In both control and CHD group,L was positively correlated with SDNN and SDANN(all P<0.001),width(W)was positively correlated with rMSSD and PNN50(all P<0.001).The detection rate of HRV abnormality in Lorenz-RR interval scatter plot was 90%,which was significantly higher than63.75%in SDNN(P<0.001).Conclusion:Lorenz plot indexes can better reflect the function of HRV than time domain indexes,which can provide reliable diagnostic basis for clinical practice.
Objective:To determine the value and relationship between Lorenz plot and time domain index of the heart rate variability(HRV)in patients with coronary heart disease(CHD).Method:Eighty patients with CHD(CHD group)and 80 healthy controls(control group)were involved in the study.All subjects were examined by 24-hour ambulatory electrocardiogram,and HRV Lorenz-RR interval scatter plot indexes and time domain indexes were compared,and the detection rate of HRV abnormality between the two groups was compared.Result:Compared with those in the control group,SDNN,SDANN and scattergram length(L)in the CHD group were significantly decreased(all P<0.001).In both control and CHD group,L was positively correlated with SDNN and SDANN(all P<0.001),width(W)was positively correlated with rMSSD and PNN50(all P<0.001).The detection rate of HRV abnormality in Lorenz-RR interval scatter plot was 90%,which was significantly higher than63.75%in SDNN(P<0.001).Conclusion:Lorenz plot indexes can better reflect the function of HRV than time domain indexes,which can provide reliable diagnostic basis for clinical practice.
引文
[1]李海滨,姜志安,刘向东,等.监测心率变异性及QT间期离散度对介入术后患者发生心血管事件的预测价值[J].临床心血管病杂志,2015,31(6):601-603.
[2]向晋涛,李方洁,郭成军.心律的整体观:认识和解读RR间期散点图[A].面向基层心律失常的规范化及心血管疑难重症专题会议,2014,9.
[3]李方洁,向晋涛.心电散点图[M].北京:人民卫生出版社,2017:181-191.
[4]中华心血管病杂志编委会心率变异性对策专题组.心率变异性检测临床应用的建议[J].中华心血管病杂志,1998,26(4):252-55.
[5]Camm AJ,Pratt CM,Schwartz PJ,et a1.Mortality in patients after arecent myocardial infarction:a randomized,placebo-controlled trial of azimilide using heart rate variability for risk stratification[J].Circulation,2004,109(8):990-996.
[6]Wennerblom B,Lurje L,Solem J,et al.Reduced heart rate variability in ischemic heart disease is only partially caused by ischemia.An HRV sthdy before and after PTCA[J].Cardiology,2000,94(3):146-151.
[7]李多,刘晋兰,王红宇.Lorenz散点图与心率变异传统分析方法的对比研究[J].临床医药实践杂志,2009,18(3):200-202.
[8]严国平.冠心病合并糖尿病患者心率变异性时域指标及散点图分析[J].现代电生理杂志,2017,24(2):77-79.
[2]向晋涛,李方洁,郭成军.心律的整体观:认识和解读RR间期散点图[A].面向基层心律失常的规范化及心血管疑难重症专题会议,2014,9.
[3]李方洁,向晋涛.心电散点图[M].北京:人民卫生出版社,2017:181-191.
[4]中华心血管病杂志编委会心率变异性对策专题组.心率变异性检测临床应用的建议[J].中华心血管病杂志,1998,26(4):252-55.
[5]Camm AJ,Pratt CM,Schwartz PJ,et a1.Mortality in patients after arecent myocardial infarction:a randomized,placebo-controlled trial of azimilide using heart rate variability for risk stratification[J].Circulation,2004,109(8):990-996.
[6]Wennerblom B,Lurje L,Solem J,et al.Reduced heart rate variability in ischemic heart disease is only partially caused by ischemia.An HRV sthdy before and after PTCA[J].Cardiology,2000,94(3):146-151.
[7]李多,刘晋兰,王红宇.Lorenz散点图与心率变异传统分析方法的对比研究[J].临床医药实践杂志,2009,18(3):200-202.
[8]严国平.冠心病合并糖尿病患者心率变异性时域指标及散点图分析[J].现代电生理杂志,2017,24(2):77-79.