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目的研究心率震荡(HRT)在慢性心力衰竭(CHF)患者中的变化及与血浆脑钠素(BNP)间的关系。方法 70例CHF患者和53例正常对照者,CHF患者按纽约心功能分级(NYHA)分为轻度(Ⅰ～Ⅱ级)和重度(Ⅲ～Ⅳ级);所有研究对象经心超测量左心室射血分数(LVEF),同时行动态心电图(Holter)检查,计算HRT参数:震荡初始(TO)和震荡斜率(TS),采用ELISA法测定所有研究对象血浆BNP浓度。结果 CHF患者HRT现象明显减弱,TO值高于对照组,TS值低于对照组,血浆BNP水平明显升高;TS与BNP呈负相关(P<0.05)。结论 CHF患者HRT现象明显减弱,血浆BNP水平升高,可作为评判CHF患者病情严重程度的指标。
Objective To study the changes of heart rate turbulence (HRT) in patients with chronic heart failure (CHF) and its relationship with plasma brain natriuretic peptide (BNP). Methods Seventy CHF patients and 53 normal controls were enrolled in this study. Patients with CHF were divided into two groups according to New York Heart Association grading (NYHA class): mild (grade Ⅰ ~ Ⅱ) and severe (grade Ⅲ ~ Ⅳ) LVEF and Holter examination were performed to calculate the HRT parameters: initial TO (oscillation) and concussion slope (TS), and plasma concentrations of BNP in all the subjects were measured by ELISA. Results The HRT was significantly decreased in CHF patients, the TO value was higher than that in the control group, the TS value was lower than that in the control group, and the plasma BNP level was significantly increased. The TS was negatively correlated with BNP (P <0.05). Conclusions The HRT phenomenon in CHF patients is significantly weakened and plasma BNP level is elevated, which may be used as an index to judge the severity of CHF patients.