摘要
目的探讨在冠状动脉慢血流现象(Coronary Slow Flow Phenomenon,CSFP)中动态心电图的应用价值。方法本研究纳入124例接受冠脉造影检查的患者(72名男性;平均年龄65.72±9.83岁),依据血流速度,将检查中发现CSFP患者纳入观察组(n=36),而对照组(n=88)为无明显慢血流患者,对CSFP患者分别予以常规心电图和动态心电图检查,对比诊断效果;比较两组心率变异性(Heart Rate Variability,HRV)指标,探讨HRV与CSFP发生的相关性。结果动态心电图在房室早搏、心动过速、ST段改变方面的检出率,要比常规心电图高(P<0.05)。冠状动脉慢血流组的最高心率及HRV指标SDNN(所有正常窦性RR间期标准差)、PNN50(相邻窦性RR间期差值>50ms所占百分比)低于冠脉正常血流组,差异有统计学意义(P<0.05)。Logistic回归分析显示,最高心率、SDNN及PNN50是CSFP的独立危险因素。结论心率变异性与慢血流发生有关,对CSFP具有一定的预测价值;在筛查CSFP患者的过程中,动态心电图有明显的优势,检出率较高,操作简单,可重复进行,有着较高的临床应用价值。
Objective To explore the application value of dynamic electrocardiogram in coronary slow flow phenomenon(CSFP).Methods This study included 124 patients(72 males;average age 65.72±9.83 years)who underwent coronary angiography.Based on blood flow velocity,patients with CSFP identified during the examination were included in the observation group(n=36),while the control group(n=88)consisted of patients without significant slow flow.CSFP patients were given routine electrocardiogram and dynamic electrocardiogram examinations,and the diagnostic effectiveness was compared.To compare the heart rate variability(HRV)indexes between the two groups and explore the correlation between HRV and CSFP.Results The detection rate of atrial premature beats,tachycardias,and ST segment changes on ambulatory electrocardiogram was higher than that on conventional electrocardiogram(P<0.05).The maximum heart rate and heart rate variability index SDNN(standard deviation of normal-to-normal intervals)and PNN50(percentage of RR intervals differing more than 50ms from the preceding one)in the coronary slow flow group were lower than those in the coronary normal flow group,and the difference was statistically significant(P<0.05).Logistic regression analysis showed that maximum heart rate,SDNN,and PNN50were independent risk factors for CSFP.Conclusions HRV is associated with slow flow,and has some predictive value for CSFP.In the screening process of CSFP patients,dynamic electrocardiogram has obvious advantages,such as high detection rate,simple operation,repeatability,and high clinical application value.
作者
林春尧
吴毅程
苏丹
王惠歆
Lin chunyao;Wu yicheng;Su dan;Wang huixin(Zhongshan Hospital(Xiamen),Fudan University,Xiamen,361015,China)
出处
《临床心电学杂志》
2024年第5期330-334,共5页
Journal of Clinical Electrocardiology
关键词
冠状动脉慢血流现象
动态心电图
心率变异性
Coronary artery slow blood flow phenomenon
Dynamic electrocardiogram
Heart rate variability
