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目的探讨动态心电图及心率变异性对冠状动脉粥样硬化性心脏病及其严重程度的诊断价值。方法选取汕头大学医学院第二附属医院心内科行冠状动脉造影患者164例,根据冠状动脉造影结果,分为冠状动脉粥样硬化性心脏病组64例和非冠状动脉粥样硬化性心脏病组100例。根据冠状动脉粥样硬化性心脏病组冠状动脉狭窄评分不同(>2分)进一步分为轻度冠状动脉粥样硬化性心脏病组和重度冠状动脉粥样硬化性心脏病组。比较轻度冠状动脉粥样硬化性心脏病组、重度冠状动脉粥样硬化性心脏病组及非冠状动脉粥样硬化性心脏病组各项动态心电图及心率变异性指标。结果轻度冠状动脉粥样硬化性心脏病组、重度冠状动脉粥样硬化性心脏病组及非冠状动脉粥样硬化性心脏病组ST段压低、ST/心率(ST/HR)、窦性RR间期标准差(SDNN)、心率变异性三角指数(TRI)比较,差异有统计学意义(P<0.05);轻度冠状动脉粥样硬化性心脏病组、重度冠状动脉粥样硬化性心脏病组及非冠状动脉粥样硬化性心脏病组平均心率比较,差异无统计学意义(P>0.05)。重度冠状动脉粥样硬化性心脏病组平均心率低于轻度冠状动脉粥样硬化性心脏病组和非冠状动脉粥样硬化性心脏病组,差异均有统计学意义(P<0.05);轻度冠状动脉粥样硬化性心脏病组与非冠状动脉粥样硬化性心脏病组平均心率比较,差异无统计学意义(P>0.05);重度冠状动脉粥样硬化性心脏病组ST段压低、ST/HR、SDNN、TRI均低于轻度冠状动脉粥样硬化性心脏病组,轻度冠状动脉粥样硬化性心脏病组低于非冠状动脉粥样硬化性心脏病组,差异均有统计学意义(均P<0.05)。结论 ST段压低、ST/HR、SDNN、TRI对判断冠状动脉粥样硬化性心脏病及其严重程度有较高的诊断价值。
Objective To investigate the value of dynamic electrocardiogram and heart rate variability in the diagnosis of coronary atherosclerotic heart disease and its severity. Methods Sixty-four patients with coronary angiography at Department of Cardiology, Second Affiliated Hospital of Medical College of Shantou University were divided into coronary atherosclerotic heart disease group (64 cases) and non-coronary atherosclerotic heart disease group 100 cases. Coronary atherosclerotic heart disease group according to coronary artery stenosis score (> 2 points) were further divided into mild coronary atherosclerotic heart disease and severe coronary atherosclerotic heart disease. Comparison of mild coronary atherosclerotic heart disease group, severe coronary atherosclerotic heart disease group and non-coronary atherosclerotic heart disease group of dynamic ECG and heart rate variability index. Results ST segment depression, ST / HR (HR), sinus RR in patients with mild coronary atherosclerotic heart disease, severe coronary atherosclerotic heart disease and non-coronary atherosclerotic heart disease SDNN, and TRI, the difference was statistically significant (P <0.05); mild coronary atherosclerotic heart disease group, severe coronary atherosclerotic heart disease There was no significant difference in mean heart rate between group and non-coronary atherosclerotic heart disease (P> 0.05). The average heart rate in patients with severe coronary atherosclerotic heart disease was lower than that in patients with mild coronary atherosclerotic heart disease and non-coronary atherosclerotic heart disease (P <0.05) There was no significant difference in mean heart rate between patients with coronary atherosclerotic heart disease and those with non-coronary atherosclerotic heart disease (P> 0.05). ST-segment depression was lower in patients with severe coronary atherosclerotic heart disease, ST / HR, SDNN, TRI were lower than mild coronary atherosclerotic heart disease group, mild coronary atherosclerotic heart disease group than non-coronary atherosclerotic heart disease group, the difference was statistically Significance (both P <0.05). Conclusion ST-segment depression, ST / HR, SDNN and TRI have high diagnostic value in judging the severity of coronary heart disease and coronary heart disease.