窦性心律震荡对临床心血管事件的预测价值分析

目的探讨窦性心律震荡(HRT)对不同心血管疾病的预测并评价其临床应用价值。方法分析2015年1月至2016年1月在我院心内科行24h动态心电图(Holter)检测的患者,根据临床诊断分为:不稳定性心绞痛组、冠心病组,每组50例。正常对照组选择有室性期前收缩而无器质性心脏病的体检者50例。根据Holter记录资料,计算HRT的两个参数:震荡初始(TO)和震荡斜率(TS),比较心血管疾病组与正常对照组TO和TS的差异。根据不同病变程度进一步将冠心病组、不稳定性心绞痛组患者分为不同亚组,比较不同亚组间TO和TS的差异,并分析死亡组与存活组之间TO和TS的差异。结果与正常对照组相比,不稳定性心绞痛组TO值升高、TS值降低。冠心病组TO值升高、TS值降低。差异均有统计学意义(P<0.05)。不稳定性心绞痛各亚组间及冠心病各亚组间比较显示,病变越严重HRT的两参数变化越显著,死亡组患者TO值显著升高、TS值显著降低。结论心率震荡减弱或消失可作为不稳定性心绞痛及冠心病严重程度的可靠参考及预测指标。

Analysis of Predictive Value of Heart Rate Turbulence on Clinical Cardiovascular Events

Objective To investigate heart rate turbulence( HRT) predicting different cardiovascular diseases and its value on clinical application.Methods Patients who accepted hospital Holter test 24 h( Holter) in our Cardiovascular Department from January 2015 to January 2016 were divided into unstable angina group( n = 50) and coronary heart disease group( n = 50) according to clinical diagnosis.And 50 physical examinees with ventricular premature contractions without organic heart disease were selected as control.According to Holter recording data,two parameters of HRT were calculated: the initial shock( T0) and turbulence slope( TS),and the differences of T0 and TS between cardiovascular disease group and control group were compared.According to different lesion degrees,patients in coronary heart disease group and unstable angina group were respectively divided into sub groups.Then the differences of T0 and TS among sub groups were compared. And the differences of T0 and TS between death group and survival group were also compared.Results Compared with control group,the unstable angina group has a rise in T0( P < 0. 05)and depression of TS( P<0. 05).Comparison among sub groups of unstable angina patients and coronary heart disease patients indicated that the more serious the lesion was,the more significantly two parameters of HRT changed and T0 remarkably increased and TS remarkably decreased in death group.Conclusion The weakening or disappearing of heart rate turbulence can be regarded as a reliable indicator for reference and prediction of severity of unstable angina and coronary heart disease