川崎病患儿心率变异性、心率减速力与冠状动脉损害的相关性分析

Correlation of heart rate variability and heart rate deceleration capacity for children with Kawasaki disease complicated by coronary artery injury

目的:探讨川崎病合并冠状动脉(冠脉)损伤的患儿与心率变异性(HRV)、心率减速力(DC)指标及其严重程度的关系和临床价值。方法:选取2019年6月~2021年6月在华南理工大学附属第六人民医院儿科收治的160例初发川崎病患儿,所有患儿入院后均接受超声心动图检查,根据是否有冠脉损伤将其分为观察A组(合并冠脉损伤,n=68)和观察B组(无冠脉损伤,n=92),同时选取100例同期进行健康体检的儿童作为对照组。所有儿童接受24 h动态心电图监测,记录HRV和DC指标。比较三组儿童的HRV及DC指标和临床特征,同时利用一元线性Pearson回归分析其与川崎病冠脉损害是否存在关系。结果:观察A组和观察B组的DC值、RMSSD、SDNN、SDANN值均低于对照组,三组间比较差异有统计学意义(均P<0.05)。与观察B组比较,观察A组DC(P=0.005)、RMSSD(P=0.004)明显降低,两组间比较差异有统计学意义(P<0.05)。川崎病合并冠脉损害的患儿与临床特征的相关性分析:DC、RMSSD、SDNN、SDANN值和冠脉损害的结果呈正相关(P<0.05)。结论:川崎病的患儿心率变异性和DC值与冠脉损害具有较高的相关性,其在对川崎病患者发生冠脉损伤有较高的预测性。对川崎病患儿及早引入这两个指标的检查,能及早评估冠脉损伤的严重程度,识别冠脉受损的患儿,及早采取临床干预对预后有重要的意义。

Objective To investigate the relationship between heart rate variability(HRV),heart rate decelerating force(DC)and their severity and clinical value in children with Kawasaki disease complicated with coronary artery injury.Method In June 2019 to June 2021 in south China university of technology,the sixth people's hospital affiliated pediatric patients at the beginning of the 160 cases of children with Kawasaki disease were selected,all the children were examined by echocardiography after admission,according to whether there was damage to the arteries were divided into observation group group A(merge coronary lesions,n=68)and observation group B(without coronary lesions,n=92).At the same time,100 healthy children were selected as the control group.All children received holter ECG monitoring for 24 hours,and HRV and DC were recorded.Comparison of three groups of children with HRV indices and clinical features of and DC,at the same time using a yuan linear Pearson regression was used to analyze its relationship with Kawasaki disease coronary artery damage.Results The DC value,RMSSD,SDNN and SDANN values of observation groups A and B were lower than those of control group,and the differences among the three groups were statistically significant(all P<0.05).Compared with observation group B,DC(P=0.005)and RMSSD(P=0.004)of observation group A were significantly decreased,and the difference between the two groups was statistically significant.Correlation analysis between children with Kawasaki disease complicated with coronary artery damage and clinical features:DC,RMSSD,SDNN,SDANN values were positively correlated with the results of coronary artery damage(P<0.05).Conclusion HRV and DC values in children with Kawasaki disease are highly correlated with coronary artery damage,and they are highly predictive of coronary artery damage in patients with Kawasaki disease.Early introduction of these two indicators in children with Kawasaki disease can early assess the severity of coronary artery damage,identify children with coronary artery damage,and early clinical intervention has important significance for prognosis.