心率变异性在散点图指标和时域指标中的对比分析

Contrasting analysis between Lorenz plot and time domain index of heart rate variability

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.