心率变异性和NT-proBNP对冠状动脉病变严重程度评估的临床应用价值

The Clinical Value of Heart Rate Variability and NT-proBNP in Evaluating The Severity of Coronary Artery Disease

目的探讨心率变异性和NT-proBNP水平对冠状动脉病变严重程度评估的临床应用价值。方法选取2019年12月-2020年12月在我院住院可疑冠心病病人279例,入院均检测NT-proBNP水平,住院期间均行24小时动态心电图检查及冠状动脉造影术检查。根据CAG检查结果分为冠脉正常组(58例)、单支病变组(67例)、双支病变组(83例)和三支病变组(71例),分析比较各组病人HRV各指标和NT-proBNP水平。结果不同程度冠状动脉病变病人,随着冠脉病变支数增加,SDNN、SDANN、RMSSD逐渐降低(P<0.01~P<0.05),LF/HF、NT-proBNP水平逐渐升高(p<0.05和p<0.01);冠脉病变组病人SDNN、RMSSD及SDANN较冠脉正常组明显降低(p<0.01~p<0.05),NT-proBNP水平较冠脉正常组明显增高(卩<0.01)。冠脉病变组病人PNN50、HF及LF、LF/HF与冠脉病变正常组病人的差异均无统计学意义(p>0.05)。结论随着冠状动脉病变严重程度的增加,SDNN、RMSSD、SDANN逐渐降低,LF/HF和NT-proBNP水平逐渐升高,HRV和NT-proBNP可作为冠状动脉病变严重程度的评估的指标。

Objective To evaluate the clinical value of heart rate variability and NT-proBNP level in evaluating the severity of coronary artery disease.Method A total of 279 hospitalized patients with suspected coronary heart disease were selected in our hospital from December 2017 to August 2019, all patients were underwent Nt-proBNP level, 24-hour dynamic electrocardiogram monitoring and coronary angiography(CAG) examination.They were divided into normal coronary artery group(58 cases),single-vessel lesion group(67 cases),double-vessel lesion group(83 cases) and three-vessel lesion group( 71 cases)to analyze the predictive value of various HRV indexes combined with NT-proBNP level in each group. Result With the increase of the number of coronary artery lesions, SDNN, SDANN and RMSSD gradually decreased, and LF/HF and NT-proBNP levels gradually increased. SDNN, RMSSD and SDANN in the coronary artery disease group were significantly lower than those in the normal coronary artery disease group, and LF/HF and nt-probnp levels were significantly higher than those in the normal coronary artery disease group(p<0.05).PNN50, HF and LF in patients with different degrees of coronary artery disease had no statistical significance, and PNN50, HF and LF in patients with coronary artery disease and patients with normal coronary artery disease had no statistical significance(p>0.05).Conclusion With the increase in the severity of coronary artery lesions, SDNN, RMSSD, SDANN gradually decreased, and LF/HF and NT-proBNP levels gradually increased. The HRV and NT-proBNP levels could be used as the evaluation indicators of the severity of coronary artery lesions.