慢性充血性心衰患者24小时心率震荡的研究

Study on the heart rate turbulence of 24h dynamic electrocardiogram in patients with chronic congestive heart failure

目的研究并分析慢性充血性心力衰竭患者24小时动态心电图心率震荡现象的临床意义及诊治价值。方法将于2018年10月至2020年10月在我院接受检查的慢性充血性心力衰竭患者76例归入研究组,将同一时间段在我院进行健康体检的健康人士43例归入对照组,于所有受试者入院后为其实施心电监测,测定LVEF、LVEDD水平及BNP水平。结果研究组患者LVEDD、BNP、TO水平均高于对照组,LVEF及TS水平均低于对照组,两组心功能指标及心率震荡指标有显著差异(p<0.05)。慢性充血性心力衰竭患者BNP、TO水平随着心功能分级增加随之升高,TS值随之降低,差异显著(p<0.05)。慢性充血性心力衰竭患者TO及TS正常者BNP水平低于TO及TS异常者,LVEF水平高于TO及TS异常者,差异显著(p<0.05)。TO与BNP、LVEDD水平呈正相关,与LVEF水平呈负相关(p<0.05),TS水平与BNP、LVEDD及LVEF水平均呈正相关(p<0.05)。结论慢性充血性心力衰竭患者心率震荡参数与心功能、BNP等关联度较高,可作为临床评价心功能损伤程度及预后评估的重要指标。

Objective To study and analyze the clinical significance, diagnosis and treatment value of 24 h Holter heart rate turbulence in patients with chronic congestive heart failure. Methods Seventy-six patients with chronic congestive heart failure who will be examined in our hospital from October 2018 to October 2020 will be included in the study group, and 43 healthy people who have undergone physical examination in our hospital during the same time period will be included in the control group, after all subjects were admitted to the hospital, ECG monitoring was carried out to determine the levels of LVEF, LVEDD and BNP. Results The levels of LVEDD, BNP and TO in the study group were higher than those in the control group, and the levels of LVEF and TS were lower than those in the control group. There were significant differences in the indicators of heart function and heart rate turbulence between the two groups(p<0.05). The levels of BNP and TO in patients with chronic congestive heart failure increased with the increase of the cardiac function classification, and the TS value decreased, the difference was significant(p<0.05). The BNP levels of patients with chronic congestive heart failure with normal TO and TS were lower than those with abnormal TO and TS, and the LVEF level was higher than those with abnormal TO and TS, the difference was significant(p<0.05). TO was positively correlated with BNP and LVEDD levels, and negatively correlated with LVEF levels(p<0.05), and TS levels were positively correlated with BNP, LVEDD and LVEF levels(p<0.05). Conclusions In patients with chronic congestive heart failure, heart rate turbulence parameters are highly correlated with cardiac function, BNP, etc., and can be used as an important index for clinical evaluation of cardiac function damage and prognosis evaluation.