心率震荡及变异与冠心病相关性分析及血糖的影响

Correlation analysis of heart rate turbulence and variation of coronary heart disease and the effect of blood glucose

目的 探讨窦性心率震荡、变异与冠心病的相关性及对不良事件发生的影响,分析冠心病合并2型糖尿病心率震荡及心率变异的变化情况。方法 选择冠心病患者36例,冠心病合并2型糖尿病43例,健康对照组40例,测定心率震荡、心律变异、冠脉Gensini积分及不良事件的发生情况,观察心率震荡、变异与冠心病相关性,不良事件发生情况及血糖对心率震荡、心率变异的影响。结果 PNN50、rMSSD及TS与患者冠脉的Gensini积分相关,差异有统计学意义（P〈0.01）,其中TS影响最大。冠心病合并2型糖尿病组SDNN、rMSSD、PNN50及TS水平均显著低于冠心病组和对照组,TO水平显著高于冠心病组和对照组,差异有统计学意义（P〈0.05）;不良事件发生组SDNN、rMSSD、PNN50及TS水平均显著低于未发生不良事件组,TO水平显著高于未发生不良事件组（P〈0.05）。结论：窦性心率震荡、变异与冠心病密切相关,是患者心脏不良事件发生的重要预测指标,血糖对心率震荡、变异的变化有一定影响。

Objective The heart rate turbulence , variation were detected to investigate the relationship of coronary heart disease （CHD） , effect on the adverse events occurrence and changes in patients with coronary heart disease （CHD） combined type 2 diabetes mellitus （T2DM）. Methods 36 cases of patients with CHD and 43 CHD combined with T2DM cases were collected,40 cases of healthy persons as control. HRT, HRV , Gensini score and incidence of adverse events were detected to observe the correlation to coronary artery disease and blood glucose. Results The Gensini score of patients with coronary was relate to PNN50, rMSSD and TS, the differences were significantly （ P 〈 0. 01） and the effect of TS was the greatest. Compared with CHD group and control group, SDNN, RMSSD ,pNN50 and TS of CHD combine with T2DM group were lowest and TO was highest ,the differences were significantly（P 〈 0.05） ; SDNN, RMSSD and pNN50 and TS with adverse events were lower , TO was higher（ P 〈 0.05 ）. Conclusion The heart rate turbulence and variation were closely related to coronary heart disease and they were one of important predictors for adverse cardiac events in patients. The blood glucose has a certain effect on the change of heart rate turbulence and heart rate variation.