Lorenz散点图在慢性心力衰竭患者心率变异性分析中的应用研究

目的探讨洛伦兹(Lorenz)散点图在慢性心力衰竭患者图心率变异性(HRV)分析中的应用。方法回顾性分析2017年9月至2020年9月安庆市立医院收治的34例心力衰竭患者的动态心电图检查资料,作为心衰组;选取同期行动态心电图检查的30例非心力衰竭患者作为对照组。比较2组HRV指标,包括时域频域指标:24 h内相邻窦性R-R间期标准差(SDNN)、相邻5 min R-R均值标准差(SDANN)、相邻R-R间期差值均方根(RMSSD)、相邻R-R间期>50 ms占正常心动周期比例(PNN50)、HRV三角指数;频域指标:高频(HF)、低频(LF)、LF/HF;观察2组Lorenz散点图形态、散点图长度(L)及离散度(D);分析Lorenz散点图测量值与HRV指标的相关性。结果心衰组HRV频域指标SDANN(73.56±34.309)ms]、HRV三角指数(24.99±10.91)和时域指标LF/HF(1.0)均显著低于对照组(103.13±23.41)ms、33.26±9.71、1.9],频域指标RMSSD(56 ms)、PNN50(21%)显著高于对照组(30 ms、5%),差异均有统计学意义(P<0.05)。2组Lorenz散点图形态分布比较差异有统计学意义(P<0.05);心衰组Lorenz散点图测量值D(174.71±74.15)显著低于对照组(222.76±92.69),差异有统计学意义(P<0.05)。Pearson相关性分析显示,心衰组Lorenz散点图测量值L与D均与HRV频域指标SDNN、PNN50、HRV三角指数呈显著正相关(P<0.05);与HRV时域指标HF、LF呈显著负相关(P<0.05)。结论慢性心力衰竭患者HRV指标、Lorenz散点图形态与离散度均与非心力衰竭患者有显著差异;Lorenz散点图测量值与HRV指标具有一定相关性。

Application of Lorenz scatter plots in the analysis of heart rate variability in patients with chronic heart failure

Objective To explore the application of Lorenz scatter plots in the analysis of heart rate variability(HRV)in patients with chronic heart failure.Methods A retrospective analysis was performed on dynamic electrocardiogram(ECG)data of 34 patients with heart failure(heart failure group)who were admitted to the Anqing Municipal Hospital from September 2017 to September 2020.Another 30 patients without heart failure who underwent dynamic ECG examination were enrolled as control group.HRV indexestime domain indexes:standard deviation of NN intervals(SDNN),standard deviation of all 5-min averaged intervals(SDANN),root mean square of successive differences(RMSSD),percent of the number whose difference between adjacent NN interval are more than 50 ms(PNN50),HRV triangle index.frequency domain indexes:high frequency(HF),low frequency(LF),LF/HF]were compared between the two groups.The morphology of Lorenz scatter plots,length(L)and discreteness(D)in both groups were observed.The correlation between the measured values of the Lorenz scatter plot and the HRV index was analyzed.Results SDANN(73.56±34.309)ms],HRV triangle index(24.99±10.91)and LF/HF(1.0)in heart failure group were significantly lower than those in control group(103.13±23.41)ms,33.26±9.71,1.9],while RMSSD(56 ms)and PNN50(21%)were significantly higher than those in control group(30 ms,5%),the differences were statistically significant(P<0.05).There were significant differences in the morphological distribution of Lorenz scatter plots between the two groups(P<0.05).The measured value D in heart failure group(174.71±74.15)was significantly lower than that in control group(222.76±92.69),the differences was statistically significant(P<0.05).Pearson correlation analysis showed that L and D were significantly positively correlated with HRV frequency domain indexes(SDNN,PNN50,HRV triangle index),while significantly negatively correlated with HRV time domain indexes(HF,LF)(P<0.05).Conclusion There are significant differences in HRV indexes,morphology of Lorenz scatter plots and discreteness between chronic heart failure and without heart failure patients.The measurement values of Lorenz scatter plots are correlated with HRV indexes.