摘要
目的探讨动态心电图(DCG)检查心率变异性指标对行经皮冠脉介入术(percutaneous coronary intervention,PCI)治疗的冠心病合并心衰患者预后的预测价值。方法选取河南中医药大学第五临床医学院(郑州人民医院)2020年2月至2021年7月接收的冠心病合并心衰患者94例作为研究组,另选同期健康体检者105例作为健康对照组,对比两组DCG检查的心率变异性指标[全程全部NN间期标准差(SDNN)、24 h内每5 min一般正常RR期间标准差平均值(SDNNI)、24 h内每5 min NN间期均值标准差(SDANN)、全程相邻NN间期差的均方根值(r MSSD)],研究组行PCI术治疗后,对比不同预后患者的DCG检查心率变异性指标,并分析DCG检查的心率变异性指标对患者预后的预测价值。结果研究组r MSSD、SDNNI、SDANN、SDNN低于健康对照组(P<0.001);且随心功能分级升高,各项指标逐渐降低(P<0.001);PCI术后,预后良好患者r MSSD、SDNNI、SDANN、SDNN高于预后不良患者(P<0.001);ROC曲线结果指出,联合检测对预测冠心病合并心衰患者预后具有较高的敏感性、特异性。结论冠心病合并心衰患者r MSSD、SDNNI、SDANN、SDNN处于较低状态,能有效评估患者的病情严重程度,且对患者的预后具有较好的预测价值。
Objective To investigate the prognostic value of dynamic electrocardiogram(DCG)in detecting heart rate variability(HRV)in coronary heart disease(CHD)patients with heart failure(HF)undergoing percutaneous coronary intervention(PCI).Methods A total of 94 CHD patients with HF treated in the Fifth Clinical Medical College of Henan University of Chinese Medicine(People's Hospital of Zhengzhou)from February 2020 to July 2021 were as the study group,and 105 health volunteers receiving physical examinations during the same period were selected as the healthy control group.The HRV indexes including the standard deviation of the NN intervals(SDNN),SDNN index(SDNNI)every 5 minutes within 24 hours,standard deviation of the 5-min averaged NN intervals(SDANN)within 24 hours,and root mean square of successive NN interval differences(rMSSD)were compared between groups.The HRV indexes of DCG examination in patients with different prognosis after PCI were compared,and the predictive value of that for the prognosis of patients was identified.Results rMSSD,SDNNI,SDANN,and SDNN in the study group were significantly lower than those in the healthy control group(P<0.001).rMSSD,SDNNI,SDANN,and SDNN decreased with the increase in cardiac function grade of patients in the study group.After PCI,rMSSD,SDNNI,SDANN,and SDNN were significantly higher in patients of study group with a good prognosis than those with a poor prognosis(P<0.001).ROC curves showed that the combined detection of rMSSD,SDNNI,SDANN and SDNN had high sensitivity and specificity in predicting the prognosis of CHD with HF after PCI.Conclusion rMSSD,SDNNI,SDANN,and SDNN are low in CHD patients with HF,which can effectively evaluate the disease severity and predict the prognosis of CHD with HF after PCI.
作者
李彦慧
程慧磊
杜亚丽
LI Yan-hui;CHENG Hui-lei;DU Ya-li
出处
《中国疗养医学》
2023年第6期652-655,共4页
Chinese Journal of Convalescent Medicine
关键词
冠心病
心力衰竭
经皮冠脉介入术
动态心电图
预后
Coronary heart disease
Heart failure
Percutaneous coronary intervention
Dynamic electrocardiogram
Prognosis
