心率变异性与慢性阻塞性肺疾病患者病情严重程度的相关性分析

Analysis of Correlation between Heart Rate Variability and Severity of Chronic Obstructive Pulmonary Disease

目的:探讨心率变异性(HRV)对慢性阻塞性肺疾病(COPD)病情严重程度的评估价值。方法:选取2020年1月—2021年1月北京大学第三医院崇礼院区收治的COPD住院患者50例为研究对象,依据患者病情严重程度分为COPDⅠ级、Ⅱ级、Ⅲ级、Ⅳ级。评估不同严重程度COPD患者HRV参数变化,分析COPD患者HRV参数变化与病情严重程度的关系。结果:不同病情严重程度COPD患者R-R间期标准差(SDNN)、5 min窦性R-R间期均值标准差(SDANN)、相邻R-R间期差>50 ms的个数占总心搏数百分比(PNN50)、相邻R-R间期差值的均方根(RMSSD)水平比较,差异有统计学意义(P<0.001);随病情严重程度升高SDNN、SDANN、PNN50、RMSSD水平降低,差异有统计学意义(P<0.05)。SDNN、SDANN、PNN50、RMSSD与FEV1%预计值呈正相关,与12个月内急性加重次数呈负相关(P<0.05)。结论:HRV参数水平变化可反映COPD病情进展,临床在治疗COPD患者时需密切关注,并针对患者HRV参数下降进行干预,以降低患者死亡率,HRV可作为临床评估COPD患者病情严重程度参考指标。

Objective:To investigate the value of heart rate variability(HRV)in evaluating the severity of chronic obstructive pulmonary disease(COPD).Methods:A total of fifty patients with COPD admitted to Chongli Branch,Peking University Third Hospital from January 2020 to January 2021 were selected as the study objects.According to the severity of the patients,they were divided into COPD gradeⅠ,Ⅱ,ⅢandⅣ.The changes of HRV parameters in COPD patients with different severity were evaluated,and the relationship between the changes of HRV parameters and the severity of COPD patients was analyzed.Results:Comparison of R-R interval standard deviation(SDNN),5-minute sinus interval mean standard deviation(SDANN),percentage of adjacent R-R interval difference>50 ms in total stroke count(PNN50)and root mean square(RMSSD)of adjacent R-R interval difference in COPD patients with different severity,the difference was statistically significant(P<0.001).The levels of SDNN,SDANN,PNN50 and RMSSD decreased with the increase of disease severity,and the difference was statistically significant(P<0.05).SDNN,SDANN,PNN50 and RMSSD were positively correlated with the predicted value of FEV1%,and negatively correlated with the number of acute exacerbations within 12 months(P<0.05).Conclusion:Changes in the level of HRV parameters can reflect the progression of COPD.In the clinical treatment of COPD patients,close attention should be paid to the decrease of HRV parameters,and intervention should be carried out to reduce the mortality of patients.HRV can be used as a reference index for clinical evaluation of the severity of COPD patients.