摘要
目的探讨川崎病(KD)患儿的心率变异性(HRV)指标与肌钙蛋白I(c Tn I)和氨基末端脑钠肽前体(NT-pro BNP)的相关性及其在预后中的应用价值。方法将130例KD患儿分为冠状动脉损害组(n=47,CAL组)和无CAL组(n=83,NCAL组),同期选取110例健康儿童为对照组,29例非心血管疾病恢复期患儿为非KD组。各组儿童均行长程HRV指标检测及分析。检测KD组及非KD组患儿血清NT-pro BNP及c Tn I水平。结果同年龄性别KD组患儿正常窦性N-N间期标准差(SDNN)、相邻N-N间期标准差的平均值(SDNNindex)、相邻N-N间期之差>50 ms的心搏数占心搏总数的百分数(PNN50)、极低频功率(VLF)、低频功率(LF)和高频功率(HF)值较对照组均明显下降,LF/HF值较对照组升高(P<0.05)。CAL组SDNN、全部记录中每5 min N-N间期平均值的标准差(SDANN)、SDNNindex、相邻N-N间期差值的均方根值(r MSSD)、PNN50、VLF、LF和HF值均低于对照组和非KD组,LF/HF值高于对照组(P<0.05)。CAL组及NCAL组的c Tn I和NT-pro BNP水平均高于非KD组(P<0.05)。KD患儿c Tn I与SDNN、HF呈负相关,与LF/HF呈正相关(P<0.05);NT-pro BNP与SDNN、SDANN、HF呈负相关(P<0.05)。结论 HRV指标对KD患儿的CAL判断具有一定的临床意义。
Objective To explore the correlation of heart rate variability （HRV） indices with cardiac troponin I （cTnI） and N-terminal pro-B-type natriuretic peptide （NT-proBNP） in children with Kawasaki disease （KD） and their prognostic value. Methods A total of 130 children with KD were assigned into coronary artery lesion （CAL） group （n=47） and non-coronary artery lesion （NCAL） group （n=83）. Meanwhile, 110 healthy children and 29 children in the recovery stage of non-cardiovascular diseases were selected as control and non-KD groups, respectively. Patients in the four groups received 24-hour HRV monitoring. Levels of serum cTnI and NT-proBNP were measured in the KD and the non-KD group. Results Compared with the controls of the same sex and age, the KD patients had signiifcantly reduced standard deviation of all normal sinus RR intervals （SDNN）, mean of SDNN （SDNN index）, percentage of successive normal sinus RR intervals〉50 ms （pNN50）, very low frequency （VLF）, low frequency （LF）, and high frequency （HF） but a signiifcantly increased LF/HF ratio （P〈0.05）. The HRV indices including SDNN, standard deviation of all mean 5-minute RR intervals （SDANN）, SDNN index, root mean squared successive difference, pNN50, VLF, LF, and HF in the CAL group all signiifcantly decreased compared with those in the control and non-KD groups, while the LF/HF ratio was higher in the CAL group than in the control group （P〈0.05）. The serum levels of cTnI and NT-proBNP in the CAL and NCAL groups were signiifcantly higher than those in the non-KD group （P〈0.05）. In children with KD, serum cTnI level was negatively correlated with SDNN and HF but positively correlated with the LF/HF ratio （P〈0.05）;serum NT-proBNP level was negatively correlated with SDNN, SDANN, and HF （P〈0.05）. Conclusions HRV indices have certain clinical signiifcance in assessing CAL of children with KD.
出处
《中国当代儿科杂志》
CAS
CSCD
北大核心
2015年第6期607-612,共6页
Chinese Journal of Contemporary Pediatrics
基金
四川省卫生厅课题(120515)
关键词
川崎病
心率变异性
肌钙蛋白I
氨基末端脑钠肽前体
儿童
Kawasaki disease
Heart rate variability
Cardiac troponin I
N-terminal pro-B-type natriuretic peptide
Child
