CAJ | 학술논문

目的：探讨心率减速力与冠状动脉病变范围和严重程度的相关性。方法纳入本院同时接受320排动态容积CT冠状动脉造影检查和24 h动态心电图(24 h DCG)监测的住院患者共270例,同时收集患者吸烟史、血脂、血糖、血压等临床指标。根据冠状动脉CT结果分为冠心病组、对照组。分析两组患者的临床指标和心率减速力( DC值)、心率加速力( AC值)和猝死危险分层的差异,判断DC值、AC值和猝死风险分层与冠脉病变严重程度、病变范围的相关性。结果冠心病组的总胆固醇( TC)、甘油三酯( TG)、低密度脂蛋白胆固醇( LDL-C)、载脂蛋白A (ApoA)水平均较对照组增高,载脂蛋白B(ApoB)则较对照组下降(P<0.05)。相比对照组,冠心病组的DC值明显下降,AC值明显升高,猝死危险分层则明显升高,差异具有统计学意义。 DC值与猝死危险分层、冠脉病变支数、Gensini评分均呈负相关,AC值与猝死危险分层、病变支数、Gensini评分均呈正相关,猝死危险分层与病变支数、Gensini评分均呈正相关,差异具有统计学意义。结论心率减速力能够定量评估自主神经,与冠状动脉病变程度、病变范围密切相关,是冠状动脉粥样硬化性心脏病的一项重要预测指标。
목적：탐토심솔감속력여관상동맥병변범위화엄중정도적상관성。방법납입본원동시접수320배동태용적CT관상동맥조영검사화24 h동태심전도(24 h DCG)감측적주원환자공270례,동시수집환자흡연사、혈지、혈당、혈압등림상지표。근거관상동맥CT결과분위관심병조、대조조。분석량조환자적림상지표화심솔감속력( DC치)、심솔가속력( AC치)화졸사위험분층적차이,판단DC치、AC치화졸사풍험분층여관맥병변엄중정도、병변범위적상관성。결과관심병조적총담고순( TC)、감유삼지( TG)、저밀도지단백담고순( LDL-C)、재지단백A (ApoA)수평균교대조조증고,재지단백B(ApoB)칙교대조조하강(P<0.05)。상비대조조,관심병조적DC치명현하강,AC치명현승고,졸사위험분층칙명현승고,차이구유통계학의의。 DC치여졸사위험분층、관맥병변지수、Gensini평분균정부상관,AC치여졸사위험분층、병변지수、Gensini평분균정정상관,졸사위험분층여병변지수、Gensini평분균정정상관,차이구유통계학의의。결론심솔감속력능구정량평고자주신경,여관상동맥병변정도、병변범위밀절상관,시관상동맥죽양경화성심장병적일항중요예측지표。
Objective To investigate the relationship between the deceleration capacity of rate and the severity of coronary artery lesions. Methods 270 patients were performed 320 slices spiral CT and 24 hours Holter recording from Jul 2012 to Jun 2013. Age,gender,smoking,blood glucose and blood lipids were recorded. All cases were divided into two groups including coronary atherosclerosis group and control group according to the results of coronary CT angiography. The relationships between deceleration capacity of rate (DC),acceleration capacity (AC),risk stratifications of sudden death and the severity of coronary artery lesions were analyzed. Results CHOL,TRIG,LDL-C and ApoA in coronary athero-sclerosis group were significantly higher than those in control group(P<0. 05). ApoB in coronary atherosclerosis group was significantly lower than that in control group(P<0. 05). DC in coronary atherosclerosis group was significantly lower than that in control group. AC in coronary atherosclerosis group was significantly higher than that in control group. The risk strati-fication of sudden death in coronary atherosclerosis group was significantly higher than that in control group. Negative corre-lation between the risk stratification of sudden death,the number of coronary artery stenosis,Gensini score and DC was ob-served(P<0. 05). Positive correlation between the risk stratification of sudden death,the number of coronary artery steno-sis,Gensini score and AC was observed(P<0. 05). The risk stratification of sudden death was positively correlated with the number of coronary artery stenosis and Gensini score(P<0. 05). Conclusion DC can quantitatively assess autonomic nervous function. DC was associated with the severity and scope of coronary artery stenosis. DC was an important predictor of coronary artery disease.