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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、r MSSD、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,r MSSD,p NN50,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。
Objective To investigate the correlation between heart rate variability (HRV), plasma homocysteine (Hcy) and coronary artery disease in patients with coronary heart disease. Methods A total of 278 coronary heart disease patients diagnosed as coronary heart disease were enrolled in our hospital. According to the Gensini score, they were divided into mild coronary stenosis group (76 cases), moderate group (109 cases) and severe group (93 cases) . Routinely measure plasma homocysteine levels and 24h ambulatory electrocardiographic monitoring, record HRV indexes, analyze the difference of HRV index and plasma Hcy levels among different groups, and analyze the relationship between HRV and plasma Hcy levels and the severity of coronary lesions Correlation. Results The level of Hcy increased with the increase of Gensini score, and there was significant difference between the three groups (P <0.05). The levels of SDNN, SDANN, r MSSD, PNN50, LF / HF The difference of parameters was statistically significant (P <0.05), and HRV index decreased with the severity of coronary lesions. Pearson correlation analysis showed that SDNN, SDANN, MSSD, p NN50, LF / HF and Gensini scores were Negative correlation (all P <0.05), Hcy and Gensini score was positively correlated (P = 0.01). Logistic multivariate regression analysis showed that Hcy and HRV were independent related factors to aggravate coronary artery disease in patients. Conclusion The levels of HRV and plasma Hcy in patients with coronary heart disease are correlated with the degree of coronary artery disease.