冠心病患者应用动态心电图对其心脏自主神经功能的评价研究
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摘要
目的探讨冠心病患者应用动态心电图对其心脏自主神经功能的评价。方法选取2015年1月～2018年1月本院收治的冠心病患者100例,依据心脏自主神经功能分为损伤组(n=64例)和正常组(n=36例),应用动态心电图检测心脏变时功能不全(CCD)[最快、最慢、差值、平均心率(HR)]、心率变异性(HRV)[正常R-R间期标准差(SDNN)、R-R间期差值高于50ms部分占比(RNN50)、5min正常R-R间期平均值标准差(SDANN)、连续5min R-R间期差值均方根(rMSSD)、低频成分(LF)、频成分(HF)]。结果损伤组和正常组最快、最慢、差值HR比较,差异有统计学意义(P <0.05),两组平均HR比较,差异无统计学意义(P> 0.05);损伤组和正常组SDNN、RNN50、SDANN、r MSSD比较,差异有统计学意义(P <0.05),两组LF、HF比较,差异无统计学意义(P> 0.05)。结论应用动态心电图检测最快、最慢、差值HR等CCD指标和SDNN、RNN50、SDANN、r MSSD等HRV指标,可有效评价冠心病患者心脏自主神经功能,值得临床作进一步推广。
Objective To discuss the dynamic electrocardiogram being used to evaluate cardiac autonomic nervous function in patients with coronary heart disease. Methods One hundred patients with coronary heart disease who admitted to our hospital from January 2015 to January 2018 were selected and divided into injury group(n=64)and normal group(n=36)according to cardiac autonomic function.Dynamic electrocardiogram(DCG)was used to detect CCD as the fastest,the slowest,differences and heart rate(HR)and heart rate variability(HRV)such as SDNN,RNN50,SDANN,rMSSD,LF and HF. Results The differences of the fastest,slowest and HR between the injury group and the normal group were statistically significant(P < 0.05).There was no significant difference in average HR between the two groups(P > 0.05).SDNN,RNN50,SDANN and rMSSD were compared between the injury group and the normal group, and the differences were statistically significant(P < 0.05).LF and HF of the two groups were compared, and the difference was not statistically significant(P > 0.05). Conclusion The application of CCD and HRV indexes such as SDNN,RNN50,SDANN and rMSSD in the department of electrocardiography(DCG)with the fastest and most rapid detection and the slowest can effectively evaluate the cardiac autonomic nervous function of patients with coronary heart disease,which is worthy of further promotion in clinical practice.
Objective To discuss the dynamic electrocardiogram being used to evaluate cardiac autonomic nervous function in patients with coronary heart disease. Methods One hundred patients with coronary heart disease who admitted to our hospital from January 2015 to January 2018 were selected and divided into injury group(n=64)and normal group(n=36)according to cardiac autonomic function.Dynamic electrocardiogram(DCG)was used to detect CCD as the fastest,the slowest,differences and heart rate(HR)and heart rate variability(HRV)such as SDNN,RNN50,SDANN,rMSSD,LF and HF. Results The differences of the fastest,slowest and HR between the injury group and the normal group were statistically significant(P < 0.05).There was no significant difference in average HR between the two groups(P > 0.05).SDNN,RNN50,SDANN and rMSSD were compared between the injury group and the normal group, and the differences were statistically significant(P < 0.05).LF and HF of the two groups were compared, and the difference was not statistically significant(P > 0.05). Conclusion The application of CCD and HRV indexes such as SDNN,RNN50,SDANN and rMSSD in the department of electrocardiography(DCG)with the fastest and most rapid detection and the slowest can effectively evaluate the cardiac autonomic nervous function of patients with coronary heart disease,which is worthy of further promotion in clinical practice.
引文
[1]Turin T C,Okamura T,Afzal A R,et al.Impact of hypertension on the lifetime risk of coronary heart disease[J].Hypertension Research,2016,39(7):548-551.
[2]任玲.右美托咪定对老年冠心病患者围术期心脏自主神经系统功能的影响[J].现代中西医结合杂志,2016,25(18):1964-1966.
[3]Khera A V,Emdin C A,Drake I,et al.Genetic risk,adherence to a healthy lifestyle,and coronary disease[J].NEngl J Med,2016,375(24):2349-2358.
[4]张全慧.动态心电图评价急性脑卒中患者心脏自主神经功能的临床研究[J].河北医学,2016,22(3):397-400.
[5]寇锋军,王婷,王月文,等.动态心电图评价2型糖尿病患者心脏自主神经功能的价值[J].现代生物医学进展,2016,16(36):7132-7134,7181.
[6]吕俊刚,贺延,刘丽,等.老年冠心病动态心电图分析[J].山西医药杂志,2014,43(15):1805-1807.
[7]Levinsson A,Olin A C,Bjerck L,et al.Nitric oxide synthase(NOS)single nucleotide polymorphisms are associated with coronary heart disease and hypertension in the INTERGENE study[J].Nitric Oxide,2014,39(1):1-7.
[8]李淑荣,刘洵,陈彦平,等.康复运动对冠心病患者心脏自主神经功能的影响[J].中国康复医学杂志,2014,29(7):619-623.
[9]Bittencourt M S,Hulten E,Polonsky T S,et al.European society of cardiology-recommended coronary artery disease consortium pretest probability scores more accurately predict obstructive coronary disease and cardiovascular events than the diamond and forrester score:the partners registry[J].Circulation,2016,134(3):201-211.
[10]魏珍珍,盖海云,韩勇.温心汤对冠心病缓慢性心律失常患者心脏自主神经功能的影响[J].中医药导报,2018,24(8):109-112.
[11]夏国宏,郑争达,杨海燕.动态心电图检查老年冠心病心肌缺血和心律失常临床价值分析[J].医学影像学杂志,2016,26(2):354-356.
[12]林晓明,杨希立,刘鹤龄,等.冠心病患者心脏变时功能不全对预后的预测价值[J].实用医学杂志,2014,30(13):2185-2186.
[13]李献良,姜先雁,蒋文彬,等.螺内酯联合贝那普利对急性前壁心肌梗死患者左心室重构及心率变异性的影响[J].中国医药科学,2016,6(14):192-195.
[14]刘博淼,刘洵,王一春,等.12周运动康复对冠心病患者心脏变时性功能和心率恢复值的影响[J].中国康复医学杂志,2016,31(7):765-769.
[15]田国祥,宋慧敏,张婕,等.不同年龄段老年冠心病患者心率变异性研究[J].中国循证心血管医学杂志,2015,7(4):544-546.
[2]任玲.右美托咪定对老年冠心病患者围术期心脏自主神经系统功能的影响[J].现代中西医结合杂志,2016,25(18):1964-1966.
[3]Khera A V,Emdin C A,Drake I,et al.Genetic risk,adherence to a healthy lifestyle,and coronary disease[J].NEngl J Med,2016,375(24):2349-2358.
[4]张全慧.动态心电图评价急性脑卒中患者心脏自主神经功能的临床研究[J].河北医学,2016,22(3):397-400.
[5]寇锋军,王婷,王月文,等.动态心电图评价2型糖尿病患者心脏自主神经功能的价值[J].现代生物医学进展,2016,16(36):7132-7134,7181.
[6]吕俊刚,贺延,刘丽,等.老年冠心病动态心电图分析[J].山西医药杂志,2014,43(15):1805-1807.
[7]Levinsson A,Olin A C,Bjerck L,et al.Nitric oxide synthase(NOS)single nucleotide polymorphisms are associated with coronary heart disease and hypertension in the INTERGENE study[J].Nitric Oxide,2014,39(1):1-7.
[8]李淑荣,刘洵,陈彦平,等.康复运动对冠心病患者心脏自主神经功能的影响[J].中国康复医学杂志,2014,29(7):619-623.
[9]Bittencourt M S,Hulten E,Polonsky T S,et al.European society of cardiology-recommended coronary artery disease consortium pretest probability scores more accurately predict obstructive coronary disease and cardiovascular events than the diamond and forrester score:the partners registry[J].Circulation,2016,134(3):201-211.
[10]魏珍珍,盖海云,韩勇.温心汤对冠心病缓慢性心律失常患者心脏自主神经功能的影响[J].中医药导报,2018,24(8):109-112.
[11]夏国宏,郑争达,杨海燕.动态心电图检查老年冠心病心肌缺血和心律失常临床价值分析[J].医学影像学杂志,2016,26(2):354-356.
[12]林晓明,杨希立,刘鹤龄,等.冠心病患者心脏变时功能不全对预后的预测价值[J].实用医学杂志,2014,30(13):2185-2186.
[13]李献良,姜先雁,蒋文彬,等.螺内酯联合贝那普利对急性前壁心肌梗死患者左心室重构及心率变异性的影响[J].中国医药科学,2016,6(14):192-195.
[14]刘博淼,刘洵,王一春,等.12周运动康复对冠心病患者心脏变时性功能和心率恢复值的影响[J].中国康复医学杂志,2016,31(7):765-769.
[15]田国祥,宋慧敏,张婕,等.不同年龄段老年冠心病患者心率变异性研究[J].中国循证心血管医学杂志,2015,7(4):544-546.