| 崔英迪,石雷雷,陈家亮.心率减速力对慢性心力衰竭患者心源性死亡的预测价值[J].,2018,(19):3648-3652 |
| 心率减速力对慢性心力衰竭患者心源性死亡的预测价值 |
| Prognostic Value of Deceleration Capacity for the Patients with Chronic Heart Failure |
| 投稿时间：2018-02-28 修订日期：2018-03-27 |
| DOI：10.13241/j.cnki.pmb.2018.19.010 |
| 中文关键词: 心率减速力 慢性心力衰竭 心源性死亡 |
| 英文关键词: Deceleration capacity Chronic heart failure Cardiac death |
| 基金项目:黑龙江省卫生厅科研基金项目（2014-292） |
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| 中文摘要: |
| 摘要 目的：探讨心率减速力(DC)对慢性心力衰竭患者心源性死亡的预测价值。方法：选择208例慢性心力衰竭(CHF)患者和80例正常对照者为研究对象，检测和比较两组DC、心率变异性(HRV)、左心室射血分数(LVEF)、左室舒张末内径(LVEDD)、C反应蛋白(CRP)和平均心率(mHR)等指标，随访6～18个月，终点事件是心源性死亡。结果：心衰患者DC较健康对照组明显下降(4.39±1.05 ms vs. 6.36±0.32 ms, P<0.001)，慢性心衰患者发生心源性性死亡较存活着DC明显减低(3.52±1.83 ms vs. 4.53±0.85 ms，P=0.002)，单变量分析年龄≥65岁、LVEF≤30%、CRP≥11.8 mg/L、SDNN≤70 ms和平均心率(mHR)≥75 次/min和DC<4.5 ms等6个变量对终点事件有预测价值；多变量分析结果显示仅年龄≥65岁、LVEF≤30%、SDNN≤70 ms和DC<4.5 ms对心源性死亡有预测价值(P<0.05)，DC相对危险度为3.14。结论：心力衰竭患者DC减低，DC是心功能慢性心力衰竭患者心源性死亡的独立危险因子。 |
| 英文摘要: |
| ABSTRACT Objective: To evaluate the prognostic value of deceleration capacity(DC) for predicting cardiac death in CHF patients. Methods: 208 cases of chronic heart failure(CHF) patients and 80 normal controls were enrolled, the DC, HRV, left ventricular ejection fraction (LVEF), left ventricular end diastolic diameter (LVEDD), C-reactive protein(CRP) and mean heart rate(mHR) were recorded, then the patients were followed up for 6-18 months, the end point were cardiac death. Results: DC were significantly lower in the CHF group than that of the healthy group(4.39±1.05 ms vs 6.36±0.32 ms, P<0.001), DC was significantly lower in the cardiac deaths group than that of the survival group(3.52±1.83 ms vs 4.53±0.85 ms, P=0.001). Univariate analysis showed that DC<4.5 ms, age≥65 years,LVEF≤30%, SDNN≤70 ms, CRP≥11.8 mg/L and RHR≥75 bpm could predict the end point. Multivariate analysis showed that only LVEF≤30%, SDNN≤70 ms and DC<4.5 ms had predictive values. The relative risk of DC was 3.14. Conclusion: DC was decreased in the patient with CHF and was an independent risk factor for the cardiac death in CHF patients. |
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