冠心病患者心率变异性及血浆同型半胱氨酸水平与冠脉病变程度有相关性

目的 探讨冠心病患者心率变异性(HRV)、血浆同型半胱氨酸(Hcy)水平与冠脉病变程度的相关性。方法 我院心内科住院冠脉造影确诊为冠心病患者278例，根据Gensini评分法将其分为冠状动脉狭窄轻度组（76例）、中度组（109例）和重度组（93例）。常规检测各组血浆Hcy水平，以及进行24h动态心电监测，并记录HRV指标，分析比较各组间HRV指标和血浆Hcy水平的差异以及分析HRV和血浆Hcy水平与冠脉病变严重程度之间的相关性。结果 Hcy水平随着Gensini评分值升高而升高，轻、中、重度3组间比较差异具有统计学意义(P<0.05)；3组间SDNN、SDANN、rMSSD、PNN50、LF/HF等参数差异具有统计学意义(P<0.05)，且随着冠脉病变程度的加重，HRV指标数值逐渐降低；Pearson相关分析显示SDNN，SDANN，rMSSD，pNN50，LF/HF与Gensini评分值呈负相关（均P<0.05），Hcy与Gensini评分呈正相关（P=0.01）。Logistic多因素回归分析表明，Hcy、HRV是加重患者冠状动脉病变的独立相关因素。结论 冠心病患者HRV及血浆Hcy水平与冠脉病变程度有相关性。

Correlation of plasma homocysteine and heart rate variability with severity of coronary artery heart disease

AIM To investigate the relationship between plasma homocysteine, heart rate variability (HRV) and severity of coronary artery heart disease (CAD). METHODSTwo hundred and seventy-eight patients with CAD confirmed by coronary angiography (CAG) were divided into three groups by Gensini scoring: minimal group (n=76), moderate group (n=109) and severe group (n=93), and 61 non-CAD patients were assigned to control group. Plasma homocysteine was detected, 24-h ambulatory electrocardiogram was performed and the index of HRV was recorded. The results were analyzed and compared. RESULTSPlasma homocysteine levels increased with the Gensini scores and a significant difference was found between minimal, moderate and severe groups (P<0.05). The index of HRV had a decreasing trend with the increasing extent and severity of coronary artery lesion (P<0.05). Plasma Hcy level and the index of heart rate variability were associated with severity of CHD. Hcy and HRV were risk factors for coronary artery disease. CONCLUSIONHRV and plasma Hcy are closely related to the severity of CAD and have some value in predicting the severity of CHD.