摘要
目的研究心率震荡(Heart Rate Turbulence HRT)在慢性充血性心力衰竭(congestiveheart failure,CHF)患者中的变化及其与血浆脑钠素(brain natriuretic peptide BNP)间的关系。方法66例CHF患者和29例正常对照者,均记录临床资料,CHF患者按纽约心功能分级(NYHA)分为轻度CHF组(NYHAⅠ-Ⅱ级)和重度CHF组(NYHAⅢ-Ⅳ级);根据病因不同分为缺血性心脏病组和非缺血性心脏病组。所有研究对象经超声心动图测量左心室射血分数(LVEF)左室舒张末期内径(LVEDD),同时行动态心电图(Holter)检查,计算机专用软件自动计算HRT的两个参数:震荡初始(Turbulence Onset,TO)和震荡斜率(Turbulence Slop,TS),采用ELISA法测定所有研究对象血浆BNP的浓度。结果CHF患者HRT现象明显减弱,TO值高于对照组(P<0.05),TS值低于对照组(P<0.05);重度CHF患者TS值明显低于轻度CHF患者(P<0.05),两组间TO值无显著性差异(P>0.05);缺血性心脏病和非缺血性心脏病患者HRT变化规律无明显差异(P>0.05);CHF患者血浆BNP水平明显升高(P<0.05);重度CHF患者血浆BNP高于轻度CHF患者(P<0.05);TO值与LVEDD、LVEF、BNP、TS值年龄无明显相关性(P>0.05);TS与LVEDD、BNP呈负相关(P<0.05),与LVEF呈正相关(P<0.05);BNP与LVEF呈负相关(P<0.05),与LVEDD呈正相关(P<0.05)。结论CHF患者心率震荡现象明显减弱,重度CHF患者TS减弱更为明显,可作为评判CHF患者病情严重程度的指标;CHF患者血浆BNP水平升高,重度CHF患者升高更为明显,CHF患者TS值与血浆BNP间有良好相关性。
Objective The character of HRT and relationship with plasma BNP in chronic congestive heart failure （CHF） patients. Methods 66 CHF patients and 29 health person were enrolled. CHF patients were classified into mild group （ NYHA Ⅰ - Ⅱ ） and severe group （ NYHA Ⅲ-Ⅳ ） according to NYHA classification; ischemic heart disease group and nonisehemic heart disease group according to etiopathogeni- sis. Left ventricular ejection fraction （LVEF）and left ventricular end-diastolic diameter （LVEDD） were measured by echocardiography. Turbulence onset（TO） and turbulence slope（TS） were calculated from Holter records. The plasma brain natriuretic peptide（BNP） level of the CHF patients and the controls were meas- ured with ELISA method. Results The TO of the CHF patients were significantly higher than those of the control group（ P 〈 0.05 ）, The TS were significantly lower than those of the control group （P 〈 0.05 ） ; The TO of the severe group were higher than those of the mild group （ P 〈 0.05 ）, The TS of the severe group were lower than those of the mild group （P 〈 0.05 ） ;There was no significant difference of TO and TS between ischemic heart disease group and nonischemic heart disease group （ P 〉 0.05 ）. The plasma brain natriuretic peptide（BNP） level of the CHF patients were significantly higher than those of the control group （P 〈 0.05）, The plasma BNP of the severe group were higher than those of the mild group（P 〈0.05） ; 0.01 ）. TO were negatively related to LVEF and positivel related to LVEDD,plasma BNP . There was no significant correlation between TO and age,TS（ P 〉0.05 ） ; TS were positivel related to LVEF and negatively related to LVEDD,plasma BNP . There was no significant correlation between TS and age;TS （P 〉 0.05 ） ;BNP were pesitivel related to LVEDD and negatively related to LVEF. Conclusions HRT decreased significantly in CHF patients, TS decreased significantly in the severe group of CHF patients. It suggested
出处
《中国分子心脏病学杂志》
CAS
2009年第4期231-236,共6页
Molecular Cardiology of China
