心率变异性与冠状动脉病变及其严重程度的相关性分析

Analyses of the correlation between heart rate variability and coronary lesion

目的 :分析心率变异性 (HRV)各指标与冠状动脉病变及其严重程度的相关性。方法 :选择 12 6例同期行冠状动脉造影 (CAG)和 2 4h动态心电图 (AECG)监测的患者 ,按CAG结果分为阳性组和阴性组 ,对AECG所获得的HRV各项指标进行统计学分析和比较。结果 :①HRV中的SDNN、TRI、VLI、RMSSD、PNN5 0指标在CAG阳性与CAG阴性两组间比较差异有统计学意义 (P <0 .0 1) ,其中总体标准差 (SDNN)、HRV三角指数(TRI)、矢量长度指数 (VLI)在单支、双支、三支病变患者间比较差异亦有统计学意义 (P <0 .0 1) ,而HRV中的低频与高频功率的比值、VAI在上述组间比较差异均无统计学意义。②多元Logistic回归及多元线性回归分析显示 :SDNN、TRI、VLI下降程度与冠状动脉病变范围及程度呈负相关。③PoincarePlot散点图在CAG阳性与CAG阴性组间差异有统计学意义 (P <0 .0 1) ,CAG阳性组中彗星状散点图明显减少 ,非彗星状散点图明显增多 ,其中尤以鱼雷状散点图增多明显。④CAG阳性与CAG阴性两组间在年龄、性别、高血压、高血脂的指标上差异有统计学意义 (P <0 .0 5 )。结论 :①冠心病患者的SDNN、RMSSD、TRI、PNN50 、VLI下降 ,且SDNN、TRI、VLI下降程度与冠状动脉病变严重程度呈负相关 。

Objective:To analyze the correlation between heart rate variability (HRV) and coronary lesion. Method: We selected 126 patients who had undergone 24 h ambulatory electrocardiography (AECG) and selective coronary angiography (CAG) in the same period. The groups were divided according to the results of CAG. Then all of the data of HRV which accepted from AECG we analyzed and compared between groups. Result:①Statistic significance was found in the variables of SDNN, RMSSD, TRI, PNN50 and VLI between the groups of CAG(+) and CAG(-)(P< 0.01), and the same result was found in SDNN,TRI,VLI in the three groups of single, double and triplet coronary lesion (P< 0.01). No statistic significance was found in the variables of LH/HF and VAI. ②Multiple logistic regression and multiple linear regression had shown that negative correlation was found between the decrease extend of SDNN, TRI, VLI and the extend of coronary lesion. ③Statistic significance was found in Poincare plot between the groups of CAG(+) and CAG(-) (P< 0.01). The numbers of Comet form Poincare plot were significantly decrease in CAG(+) group. While the numbers of non-Comet form but Torpedo form Poincare plot were significantly increase in CAG(+) group. ④Statistic significance was found in the variables of age, sex, high blood pressure and high TG between the groups of CAG(+) and CAG(-).Conclusion:①SDNN, RMSSD, TRI ,PNN50 and VLI are decreaed in the patients of coronary heart disease (CHD). Negative correlation is exist between the decrease extend of SDNN, TRI, VLI and the extend of coronary lesion. SDNN, TRI and VLI are the sensitive variables of predicting autonomic neuropathy and its extend. ②Poincare plots are mostly non-Comet form in the patients of CHD. The number of Torpedo form is the most in all non-Comet form Poincare plots in the group of CHD.