血清Lp-PLA2 GGT与冠心病及冠状动脉病变严重程度的相关性分析

目的分析血清脂蛋白相关磷脂酶A2(Lp-PLA2)、γ-谷氨酰转移酶(GGT)与冠心病(CHD)及冠状动脉病变严重程度的相关性。方法选择2018-06~2019-06于郑州大学第二附属医院心内科首次就诊的170例疑似CHD患者的临床资料,根据冠状动脉造影检查结果分为CHD组(103例)和非CHD组(67例)。检测患者血清Lp-PLA2、GGT水平,分析血清Lp-PLA2、GGT与CHD及冠状动脉病变严重程度的关系。结果CHD组Lp-PLA2、GGT、甘油三酯(TG)、低密度脂蛋白(LDL)、Gensin积分水平以及合并高血压、糖尿病人数比例显著高于非CHD组(P<0.05),而高密度脂蛋白(HDL)水平显著低于非CHD组(P<0.05)。Spearman相关分析结果显示,CHD患者血清Lp-PLA2、GGT水平与冠状动脉病变支数呈正相关(rs=0.681,P=0.000;rs=0.603,P=0.000)。Pearson相关分析结果显示,CHD患者血清Lp-PLA2、GGT水平与Gensin积分呈正相关(r=0.799,P=0.000;r=0.621,P=0.000)。多因素logistic分析结果显示,较高水平的Lp-PLA₂、GGT和LDL,以及合并高血压是促进CHD发生的危险因素(P<0.05);而较高水平的HDL是抑制CHD发生的保护因素(P<0.05)。结论较高水平的血清Lp-PLA2、GGT是促进CHD发生的危险因素,可较好地反映冠状动脉病变严重程度,可作为评估CHD发生、进展的可靠指标。     

冠心病患者心率减速力、加速力与变异性的对比性研究

目的观察冠心病患者心率减速力(DC)、心率加速力(AC)与心率变异性(HRV)之间的关系。方法选择117例冠心病患者和94例非冠心病者进行24h动态心电图检查,应用DMS动态心电分析软件离线测定其24h的DC、AC值及HRV时域分析指标(SDNN、r MSSD),并比较各指标之间的关系。结果冠心病组的DC、SDNN、r MSSD降低,AC升高;DC值与平均心率之间呈负相关,与SDNN、r MSSD之间呈正相关;AC值与平均心率之间呈正相关,与SDNN、r MSSD之间呈负相关。结论 DC、AC与HRV有相关性;DC值可以定量评估冠心病(CHD)患者迷走神经张力的变化。     

2型糖尿病合并下肢动脉粥样硬化病变患者血清脂蛋白相关磷脂酶A2、25羟维生素D与同型半胱氨酸关系的研究

目的探讨T2DM合并下肢动脉粥样硬化病变(LEAD)患者血清脂蛋白相关磷脂酶A2(Lp-PLA2)、25羟维生素D[25(OH)D]与同型半胱氨酸(Hcy)之间的关系。方法选取2018年1~7月于我院内分泌科住院的100例T2DM患者,按踝肱指数(ABI)分为T2DM合并LEAD组(LEAD组)50例和T2DM无LEAD组(T2DM组)50例;同期选取我院体检中心健康人群50名为正常对照组(NC组)。ELISA法检测Lp-PLA2,电化学发光法检测25(OH)D水平,酶循环法检测Hcy水平。结果与T2DM、NC组比较,LEAD组血清Lp-PLA2、Hcy水平升高,25(OH)D水平降低(P<0.05)。Pearson相关分析显示,LEAD组血清25(OH)D水平与ABI呈正相关(P<0.05),与Lp-PLA2、Hcy、Hb A1c、TG、TC、LDL-C呈负相关(P<0.05)。多因素Logistic回归分析显示,Hb A1c、LDL-C、Lp-PLA2、25(OH)D、Hcy均为T2DM合并LEAD的危险因素。结论血清Lp-PLA2、Hcy及25(OH)D可能共同参与T2DM合并LEAD的发生发展。     

冠心病患者血清Lp-PLA2、sdLDL-C水平变化及临床意义

目的探讨冠状动脉粥样硬化性心脏病(冠心病,CHD)患者血清中脂蛋白相关性磷脂酶A2(Lp-PLA2)及小而密低密度脂蛋白胆固醇(sdLDL-C)水平变化及临床意义。方法选取于2017年3月至2018年3月于河南科技大学第一附属医院心内科确诊为CHD的患者89例为观察组,选取同期74例非CHD的患者作为对照组。收集记录两组患者的年龄、性别、体质指数(BMI)、吸烟史、高血压病史、糖尿病病史等基本资料,并根据美国心脏病协会制定的冠状动脉(冠脉)血管图像计分分段标准与Gensini积分将观察组CHD患者分为3组。检测两组受试者的血清总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、LDL-C、sdLDL-C、C反应蛋白(CRP)、Lp-PLA2等生化指标。分析血清Lp-PLA2和sdLDL-C水平与其他生化指标的相关性,分析CHD患者冠脉Gensini积分与血清Lp-PLA2和sdLDL-C关系。结果观察组患者BMI值、血清TC、TG、LDL-C、CRP、sdLDL-C和Lp-PLA2值均显著高于对照组(P0.05),血清HDL-C值显著低于对照组(P0.05)。经Pearson相关性分析得到血清Lp-PLA2水平与血清sdLDL-C水平呈正相关性(r=0.482,P0.05),血清Lp-PLA2和sdLDL-C水平均与血清TC、TG、LDL-C、CRP呈正相关(Lp-PLA2:r=0.455、0.375、0.603、0.483;sdLDL-C:r=0.583、0.538、0.592、0.366,P0.05),与血清HDL-C呈负相关(r=-0.589,-0.632,P0.05)。随着冠状动脉Gensini积分增高,观察组血清Lp-PLA2和sdLDL-C水平也相应增加(P0.05),血清Lp-PLA2和血清sdLDL-C水平与Gensini积分结果呈正相关(r=0.748、0.807,P均0.05)。结论 CHD患者血清Lp-PLA2和sdLDL-C水平的高表达与体内炎性因子的表达和脂质代谢存在相关性,二者的联合检测对评估CHD的病情发展和预后干预具有临床意义。     

原发性高血压患者踝臂指数与左心室肥厚的关系

目的探讨高血压病患者动态血压及踝臂指数(ABI)与左室质量指数(LVMI)的关系。方法 87例原发性高血压患者(无冠心病、糖尿病、慢性肾病)根据ABI水平分为ABI正常组(ABI为1.10～1.14)、ABI减低组(ABI≤0.90),两组年龄、BMI、高血压病程等差异无统计学意义。分别比较两组左心室结构及功能指标的差异,并用多元线性回归方法分析ABI与左心室肥厚(LVH)的相关性。结果 ABI减低组24 h平均SBP和LVH发生率均较ABI正常组高,差异均有统计学意义(P均<0.01)。ABI与SBP、LVMI呈负相关(r=-0.803、-0.802,P均<0.01),SBP与LVMI呈正相关(r=0.757,P<0.01)。SBP、LVMI增高分别是ABI减低的独立预测因素(β=-0.006、-0.015,P均<0.01)。结论原发性高血压患者中,ABI与LVMI有关,LVMI增高、ABI减低提示原发性高血压预后不良。     

原发性高血压患者动态脉压与心率减速力和心率变异性的相关性

目的探讨原发性高血压患者动态脉压(PP)与心率减速力(DC)和心率变异性(HRV)的相关关系。方法就诊我科的原发性高血压患者180例均给予动态血压检查,根据动态血压检测结果,按照动态PP水平分为三组:将24h平均PP40mmHg的患者作为PP1组(n=60)、将24h平均PP在40～60mmHg之间的患者作为PP2组(n=60)、将24h平均PP60mmHg的患者作为PP3组(n=60)。同时选取60例健康人作为健康对照组。分析计算所有研究对象DC值和HRV时域指标总体标准差(SDNN)、差值均方根(rMSSD)和大于50ms百分比(pNN50),比较各组患者DC和HRV时域指标并进行各指标之间相关性分析。结果原发性高血压患者DC值和HRV时域指标SDNN、rMSSD、pNN50数值水平均较健康对照组降低(P0.01),且随着PP增高而出现降低趋势(P0.05); DC和HRV时域指标SDNN、rMSSD、pNN50呈正相关(r=0.25～0.48,P0.05);动态PP与DC和HRV时域指标SDNN、rMSSD、pNN50均呈负相关(r=-0.15～-0.68,P0.05)。结论原发性高血压患者动态PP与DC和HRV时域指标呈负相关,DC和HRV时域指标呈正相关;原发性高血压患者自主神经功能受损程度与动态PP正相关。     

急性心肌梗死窦性心律震荡和心率变异性的研究

目的探讨急性心肌梗死(AMI)伴室性期前收缩患者窦性心律震荡和心率变异性(HRV)的变化和临床意义。方法随机选取本院AMI合并室性期前收缩的患者58例(心梗组)和体检健康者52例(对照组)。收集所有受检者24h平均心率、R-R间期标准差、窦性心律震荡的初始值(TO)、窦性心律震荡的斜率(TS)、肌钙蛋白I(TNI)峰值、左室射血分数(LVEF)。比较两组24h平均心率、R-R间期标准差、TO、TS。并研究窦性心律震荡和HRV指标与TNI峰值和LVEF的相关性。结果心梗组的心律震荡和HRV指标弱于对照组,差异有统计学意义(P<0.05)。心梗组的R-R间期标准差与TNI峰值呈负相关(r=-0.52,P<0.01),与LVEF呈正相关(r=0.25,P<0.05)。TO与TNI峰值呈正相关(r=0.68,P<0.01),TO与LVEF呈负相关(r=-0.49,P<0.01)。TS与TNI峰值呈负相关(r=-0.79,P<0.01),TS与LVEF呈正相关(r=0.55,P<0.01)。死亡组的R-R间期标准差、TS低于存活组,TO高于存活组,差异有统计学意义(P<0.05)。结论窦性心律震荡和HRV减弱是反映AMI严重程度和预后的有用指标。     

青海省高原地区老年高血压病人血清同型半胱氨酸水平与动脉硬化的关系

目的探讨青海省高原地区(平均海拔3,200 m)老年高血压病人血清同型半胱氨酸(homocysteine,Hcy)水平与动脉硬化的关系。方法收集老年高血压病人89例,其中伴有高Hcy者58例,单纯高血压病人31例,同期门诊健康体检者30例;对所有研究对象进行血生化及血清Hcy水平检测,并用日本Colin-VPl000型动脉硬化仪测量肱-踝脉搏波传导速度(Ba PWV)和踝臂指数(ABI),对所有检测结果进行统计学分析。结果与正常对照组及单纯高血压组比较,H型高血压组Ba PWV、Hcy明显升高,而ABI则明显降低,差异有统计学意义(P<0.05)。相关性分析显示,H型高血压组Hcy与ABI呈负相关(r=-0.739,P<0.01),与Ba PWV呈正相关(r=0.927,P<0.01)。结论血清Hcy水平增高是高原地区老年高血压发病的危险因素之一,H型高血压病人较单纯高血压病人动脉硬化严重,可能与血清Hcy水平与高血压在导致动脉硬化方面具有协同作用有关。     

急性心肌梗死患者直接冠状动脉介入治疗术后心率变异性的相关因素分析

目的研究急性心肌梗死(AMI)行直接冠脉介入治疗(PPCI)后患者炎症反应对心脏自主神经功能的影响。方法纳入2013年1-5月中国医科大学附属第一医院老年病房41例AMI患者行PPCI术后,收集入院24 h内血常规中白细胞计数(WBC)、高敏C反应蛋白(hs-CRP)、血清肌酸激酶同工酶(CK-MB)及肌钙蛋白(TnI)峰值。结果 WBC计数升高的患者血清CK-MB及TnI水平显著高于WBC正常者,且心率变异性(HRV)指标SDNN显著降低。WBC计数与TnI峰值之间呈正相关(r=0.319,P=0.042),与HRV指标R-R间期总体标准差(SDNN)呈负相关(r=-0.503,P=0.009),hs-CRP与HRV指标时域指标SDNN(r=-0.325,P=0.038)及频域指标HF(r=-0.321,P=0.041)呈负相关。结论 AMI患者行PPCI术后,WBC计数与心肌坏死面积呈正相关,且白细胞计数与hs-CRP的水平越高,心率变异性下降越显著。     

急性冠状动脉综合征患者血清脂联素和踝臂指数的变化及其相关性的研究

目的观察急性冠状动脉综合征(ACS)患者血清脂联素(APN)水平和踝臂指数(ABI)值的变化及其与ACS的相关性,评估APN和ABI在ACS发生中的价值。方法依据临床表现及冠状动脉(冠脉)造影等检查,将69例冠心病患者分为ACS组(44例)与稳定型心绞痛(SAP)组(25例),其中按狭窄所累及的血管病变支数分为:单支病变组(25例),双支病变组(20例),三支病变组(24例);根据Gensini积分分为:1～30分组(48例)、≥30分组(21例);选取冠脉造影阴性者(22例)为对照(NC)组。比较各组间APN、ABI的差异。结果 (1)APN水平、ABI值ACS组均明显低于SAP组和NC组(均为P<0.05)。(2)APN水平、ABI值随着冠脉病变支数的增加均逐渐下降,相关分析提示APN、ABI值均与病变支数呈负相关(分别为r=-0.733,P<0.01;r=-0.632,P<0.01)。(3)APN水平、ABI值随着冠脉Gensini积分的增加均逐渐下降,相关分析提示APN、ABI值与Gensini积分均呈负相关(分别为r=-0.640,P<0.01;r=-0.697,P<0.01)。(4)ACS患者血清APN与ABI值呈正相关(r=0.622,P<0.01)。结论血清APN水平、ABI值随着冠脉病变程度的加重和病变范围的扩大而降低,APN和ABI值越低,冠脉病变程度可能越严重,病变范围可能越广。     

冠心病患者窦性心率震荡及T波电交替与心率变异性的相关性分析

目的探讨冠心病患者窦性心率震荡(HRT),心率变异性(HRV)及T波电交替(TWA)变化及相关性。方法冠状动脉造影诊断为冠心病患者(冠心病组)137例,其中陈旧性心肌梗死组50例,稳定性心绞痛组87例;选择同期健康体检者101例为对照组。24h动态心电图检测各组HRT、HRV和TWA参数,进行相关性分析。结果冠心病组与对照组比较,TO值显著增高,TS值显著下降,HRV指标(SDANN,ASDNN,VLF,LF,TP,LF/HF)值显著下降,差异有统计学意义(均P<0.01);最大TWA值增大,在MV5,MV1导联差异有统计学意义(均P<0.01)。陈旧性心肌梗死组与稳定性心绞痛组比较,TS值显著下降,HRV指标(SDANN,ASDNN,VLF、LF、HF、TP)值显著降低,差异有统计学意义(均P<0.05)。TO与SDNN、ASDNN、VLF呈负相关(r=-0.18~-0.19,P<0.05),TS与VLF、LF、HF、TP、SDANN、ASDNN、rMSSD、PNN50呈正相关(r=0.22~0.46,均P<0.01)。结论同时对HRT、HRV及TWA参数比对评估,可提高对冠心病患者危险性评估的准确性和可靠性。     

冠心病合并不同程度抑郁患者心率变异性分析

目的探讨抑郁对冠心病患者心率变异性(HRV)的影响。方法将临床确诊为冠心病的120例患者应用Zung抑郁自评量表(SDS)评定抑郁状况。抑郁严重度指数<0.5为无抑郁,0.5≤抑郁严重度指数<0.6为轻度抑郁;抑郁严重度指数≥0.6为中重度抑郁,据此分为抑郁组(64例)和非抑郁组(56例),将抑郁组患者再分为轻度抑郁组(40例)和中重度抑郁组(24例)。应用24 h动态心电监测仪记录各组患者的HRV,分析抑郁对冠心病患者HRV时域指标和频域指标的影响。结果冠心病患者合并抑郁组时域指标:指定时间内所有正常窦性R-R间期总体标准差(SDNN)、指定时间内每5 min窦性R-R间期均值标准差(SDANN)、指定时间内每5min窦性R-R间期标准差的均值(SDNNDX)、指定时间内正常连续窦性R-R间期差值均方根(RMSSD)及每两个相邻R-R间期差值>50 ms的个数所占的百分比(PNN50)均显著低于非抑郁组[(83.66±15.71)ms比(111.02±25.56)ms,(77.99±18.46)ms比(89.43±14.12)ms,(45.56±10.72)ms比(53.17±14.71)ms,(37.90±9.28)ms比(44.96±17.92)ms,18.42%±4.68%比23.21%±11.79%,P<0.01或P<0.05];抑郁组频域指标:极低频功率(VLF)及低频功率(LF)显著高于非抑郁组[(160.23±44.27)Hz/ms~2比(141.78±54.19)Hz/ms~2,(353.28±43.41)Hz/ms~2比(292.81±64.63)Hz/ms~2,P<0.01],而高频功率(HF)显著低于非抑郁组(P<0.05)。抑郁严重度指数与SDNN、SDANN、SDNNDX、PNN50均显著负相关(r=-0.536、-0.250、-0.273、-0.185),抑郁严重度指数与LF和LF/HF均呈显著正相关(r=0.207、0.26)。结论合并抑郁的冠心病患者HRV降低,且抑郁程度对HRV具有显著影响。     

Heart rate variability in patients with stable coronary artery disease and aspirin resistance

Aspirin resistance as defined by failure to effectively inhibit thromboxane synthesis is associated with a higher risk of recurrent myocardial ischemia and cardiovascular death. Heart rate variability (HRV) analysis has been extensively used to identify patients at risk for increased cardiac mortality. The aim of this study was to evaluate the association between HRV and aspirin resistance in patients with stable coronary artery disease (CAD). Sixty-nine (69) consecutive patients with stable CAD were included in this study. Of the 69 patients, 18 (26%) were aspirin nonresponders. When the aspirin responders were compared with the nonresponders, there was no significant difference between the groups with respect to most clinical parameters, major cardiovascular risk factors, medical treatments, and aspirin dosages. However, the patients with aspirin resistance had a higher previous myocardial infarction history and lower left ventricular ejection fraction. Moreover, mean platelet volume, CT/EPI, CT/ADP values, LF and LF/HF ratio were higher while HF, SDNN, SDANN, and RMSSD were lower in the nonresponder group than the responders. Regarding HRV parameters, CT/ADP time was negatively correlated with SDNN (r = -0.5, P = 0.02) and HF (r = -0.4, P = 0.03), and positively correlated with LF (r = 0.6, P = 0.01) and LF/HF (r = 0.7, P = 0.001). Similarly, CT/EPI time was negatively correlated with SDNN (r = -0.4, P = 0.03), and positively correlated with LF (r = 0.5, P = 0.02) and the LF/HF ratio (r = 0.5, P = 0.02). Regression analysis revealed that the only parameters affecting SDNN and LF/HF ratio were left ventricle ejection fraction and aspirin resistance. The heart rate variability decreased and sympathetic activity increased in the patients with aspirin resistance and stable CAD. This may contribute to a higher risk of recurrent myocardial ischemia and cardiovascular death in patients with aspirin resistance.     

Heart rate variability in heart failure

BACKGROUND: Heart rate variability (HRV) depicts the functional status of the autonomic nervous system and its effects on sinus node. Recently, HRV analysis has been introduced in patients with heart failure (CHF) to identify those who are at risk of cardiac death. AIM: To analyse HRV in patients with CHF with depressed left ventricular ejection fraction (EF) and to relate HRV parameters to EF, NYHA functional class and other clinical parameters. METHODS: The study group consisted of 105 patients with CHF (88 males, 17 females, mean age 54+/-12 years); 77 patients had ischaemic cardiomyopathy, and 28 - dilated cardiomyopathy. All patients were in NYHA class II-IV and had EF <40%. The mean value of echocardiographically assessed EF was 26.9+/-8.3%. The control group consisted of 30 gender- and age-matched healthy subjects. HRV analysis was performed in the time-domain from 24-hour Holter ECG. RESULTS: All HRV variables were significantly lower in patients with CHF than in controls. Patients with NYHA class II had higher values of SDNN and SDANN than those in class III or IV. Patients with sustained or non-sustained ventricular tachycardia (VT) detected during Holter monitoring had lower SDNN and SDANN values than those without VT. Patients with diabetes had significantly lower SDNN and rMSSD values than the patients without diabetes. Similar results were found when patients with or without hypertension were compared. HRV parameters were similar in patients either with ischaemic or dilated cardiomyopathy. Also the values of EF were similar (27.4+/-8.4 vs 25.0+/-8.3%, respectively, NS). In the whole group of patients with CHF the values of SDNN and SDANN significantly correlated with EF (SDNN p<0.001, r=0.42; SDANN p<0.001, r=0.51). This correlation was stronger in the subset of patients with ischaemic cardiomyopathy (SDNN p=0.002. r=0.54; SDANN p=0.002; r=0.53) than in those with dilated cardiomyopathy (SDNN p=0.012, r=0.23; SDANN p=0.008, r=0.42). A significant negative correlation was found between all HRV parameters and NYHA class (SDNN p<0.001, r = -0.33; SDANN p<0.001, r = -0.38; rMSSD p<0.001, r = -0.13). CONCLUSIONS: HRV is depressed in patients with CHF compared with healthy subjects. Among patients with CHF, HRV is further decreased in patients with more advanced NYHA class, lower EF and in those with diabetes, hypertension or VT on Holter monitoring.     

Heart Rate Variability and Disease Characteristics in Patients with COPD

Heart rate variability (HRV) is reduced in patients with chronic obstructive pulmonary disease (COPD). However, the relationships among HRV and characteristics of COPD are unknown. The aim of this study was to characterize HRV in patients with COPD and to verify the correlation of HRV measured during rest with disease severity and pulmonary, muscular, and functional impairment. Thirty-one patients with COPD (16 male; 66 +/- 8 years; BMI = 24 +/- 6 kg/m(2); FEV(1) = 46 +/- 16% predicted) without severe cardiac dysfunction were included. HRV assessment was performed by the head-up tilt test (HUTT), and the main variables used for analysis were SDNN index, LF/HF ratio, and R-R intervals. Other tests included spirometry, bioelectrical impedance, cardiopulmonary exercise test, 6-minute walk test, respiratory and peripheral muscle force, health-related quality of life and functional status questionnaires, and objective quantification of physical activity level in daily life with the DynaPort and SenseWear armband activity monitors, besides calculation of the BODE index. There was a statistical difference in all variables of HRV between the HUTT positions (lying and standing). There was no correlation of HRV with BODE index or FEV(1). Out of the BODE index, just the BMI was correlated with SDNN and R-R intervals (r = 0.44; p < 0.05 and r = 0.37; p < 0.05, respectively). There was correlation between HRV reduction and a lower level of physical activity in daily life, besides worse health-related quality of life, functional status, and respiratory and peripheral muscle force. Cardiac autonomic function of patients with COPD is not related to disease severity but mainly to the level of physical activity in daily life.     

Heart Rate Variability in Peritoneal Dialysis Patients: What Is the Role of Residual Renal Function?

Background: The relationship between heart rate variability (HRV) and residual renal function (RRF) has not been elucidated previously. Methods: In this cross-sectional study, HRV was evaluated in 71 peritoneal dialysis patients. Patients were divided into RRF decline group, RRF stable group and anuric group. Results: RRF was negatively correlated with SDNN (r = -0.284, p = 0.017), TP (r = -0.247, p = 0.039), and HF (r = -0.238, p = 0.047). Significant sympathetic nerve activation was found in the RRF decline group (significantly lower SDNN, SDSD, RMSSD, pNN50, LF, HF, TP and higher LF/HF ratio) as compared to the RRF stable and anuric groups. Besides, significantly parasympathetic activation was found in the anuric group (the lowest LF/HF ratio as compared to the other groups (both p < 0.05). Multivariate stepwise regression analysis showed that the status of RRF was an independent factor associated with HRV parameters. Conclusion: This study showed autonomic nervous function in peritoneal dialysis patients was associated with a different status of RRF.     

充血性心力衰竭心率变异性改变及其与心室重塑的关系

目的:检测充血性心力衰竭患者心率变异性(HRV)改变,探讨其与心室重塑的关系。方法:采用Holter检查系统检测了36例CHF患者HRV指标24h正常R-R间期标准差(SDNN)、24h内每5min平均正常R-R间期的标准差(SDANN)24h内每5min的正常R-R间期标准差的平均值(SDNNI),相邻正常R-R间期差值的均方根(rMSSD),相邻正常R-R间期差值≥50ms心搏数占总R-R间期数的百分数(PNN50)及超声心动图指标左心室舒张末期内径(LVEDD),收缩末期内径(LVESD),左心室后壁舒张末期厚度(LVPWT),心室间隔舒张末期厚度(IVST),左心室射血分数(LVEF),左心室舒张早期及舒张晚期充盈速度比值(E/A)及左心室重量指数(LVMI),并以20例健康体检者为对照。结果:CHF患者HRV各时域指标均下降,与对照组相比有显著差异(P<0.05～<0.01)。多元回归分析显示SDNN,SDNNI与LVEDD,LVPWT呈负相关(r=-0.337～-0.362,P<0.05);rMSSD,PNN50与LVEDD,LVESD呈负相关(r=-0.142～-0.433,P<0.05);rMSSD、PNN50与LVEF呈正相关(r=0.387～0.464,P<0.05～<0.001)。结论:CHF患者HRV下降,并与心室重塑有关。     

盐敏感性高血压患者同型半胱氨酸水平与血压及心率变异性的相关性

目的 探讨盐敏感性高血压患者同型半胱氨酸(Hcy)水平与血压变异性（BPV）和心率变异性（HRV）之间的关系。 方法 收集2015年至2016年入住中国中医科学院广安门医院131例盐敏感高血压患者,以Hcy≥15 μmol/L为Hcy升高组,<15 μmol/L为正常组。通过对患者血压及心率的动态监测,采用SPSS 26.0统计学软件对数据进行处理,分析比较两组间血压和心率变异性相关参数。 结果 两组患者的年龄和性别构成的差异均无统计学意义。升高组Hcy水平显著高于正常组（P<0.01）;升高组24 h平均收缩压（24HASBP）、24 h平均舒张压（24HADBP）、24 h收缩压变异性(24HSBPV)和24 h舒张压变异性(24HDBPV)均显著高于正常组（P<0.01,P<0.01,P<0.05,P<0.01）;而升高组心率变异性指标所有相邻心搏R-R间期之差的标准差(RMSDD)、所有心搏的R-R间期的标准差(SDNN)、每5 min心搏 R-R 间期均值的标准差(SDANN)则显著低于正常组（P<0.05,P<0.01,P<0.01）。其中Hcy水平与24HADBP、24HDBPV、RMSSD、SDNN之间有相关性（P<0.01）,其中与RMSSD和SDNN呈负相关。且多元线性逐步回归分析显示,上述二者与Hcy水平之间具有显著影响（P<0.05）。 结论 盐敏感性高血压患者Hcy水平与BPV和HRV之间具有相关性。