窦律Lorenz散点图图形量化指标参考值初探

Preliminary study on the reference value of quantitative index of Lorenz plot of sinus rhythm

目的探讨窦性心律Lorenz散点图图形评估心率变异性的量化指标参考值。方法选择2018年11月至2019年5月在重庆三峡中心医院就诊和体检的成年人群中动态心电图检查Lorenz散点图为棒球拍形状者作为研究对象。筛选出无心血管疾病伴动态心电图无异常及心率变异性分析在正常范围的245例作为图形量化指标检测组,同时选择心率变异性异常的56例作为异常组。分别测量两组患者Lorenz散点图的长轴、短轴,并计算其面积及短轴/长轴4个图形量化指标。根据检测组测值,计算各指标的参考值范围,对比判断异常组超出参考值情况。结果检测组患者长轴参考值为814-1272ms,短轴为130-281ms,面积为81081-259295ms^(2),与异常组比较,差异有统计学意义(p<0.05);检测组患者短轴/长轴为0.14-0.26,与异常组比较,差异无统计学意义(p>0.05)。异常组中至少1项指标超出参考值者有46例(82.14%)。结论建立窦性心律Lorenz散点图棒球拍形图形量化指标参考值范围,可客观准确判断心率变异性,有助于Lorenz散点图评价心率变异性的临床应用。

Objective To explore the reference value of the quantitative index of Lorenz plot graph to evaluate heart rate variability(HRV). Methods The adult population who visited Chongqing Three Gorges Central Hospital from November 2018 to May 2019 and whose Lorenz plots of dynamic electrocardiograms was baseball racket shapes were selected as the research objects.245 patients with no cardiovascular disease, no abnormality in dynamic electrocardiogram, and HRV within the normal range were selected as the graphical quantitative index testing group.At the same time, 56 patients with abnormal HRV were selected as abnormal group. Measure the long axis(LA) and short axis(SA) of the baseball racket pattern, and calculate the area and SA/LA. Calculate the reference value range of each index in the testing group, and then compare the case where the abnormal group exceeds the reference value.Results The LA reference value of the testing group is 814-1272 ms, the SA is 130-281 ms, and the area is81081-259295 ms^(2). Compared with the abnormal group, the difference was statistically significant(p<0.05). The SA/LA reference value was 0.14-0.26, compared with the abnormal group, the difference was not statistically significant(p>0.05). In the abnormal group,46 cases(82.14%) at least one index exceeded the reference value.Conclusions The establishment of the reference value range of the quantitative index of the sinus rhythm Lorenz plot baseball bat shape graph can objectively and accurately judge the HRV, which is helpful for the clinical application of the Lorenz plot to evaluate the HRV.