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目的研究一种基于短时心率变异性分析的充血性心力衰竭(congestive heart failure,CHF)患者心功能级别评定方法。方法选择符合纽约心脏病协会(NYHA)心功能分级Ⅱ、Ⅲ级的临床48例CHF患者,按照心功能分级分为2个组:心功能Ⅱ级CHF患者25例和Ⅲ级CHF患者23例。采集每例患者约10 min标准肢体Ⅱ导联心电信号,提取R波波峰位置,构造心电间期序列。根据心电间期序列,提出一种新的心率变异性图形化分析方法——RR间期序列归一化直方图,定义RR间期序列归一化直方图的量化评价指标——模糊区间信息熵。采用统计学分析方法检验两组CHF患者在指标模糊区间信息熵上有无显著统计学差异。结果成组t检验结果显示两组间有显著统计学差异(P=0.001)。结论 RR间期序列归一化直方图构造方法,可用于临床CHF患者的心功能评级。
Objective To investigate a method for assessing cardiac function in patients with congestive heart failure (CHF) based on short-term analysis of heart rate variability. Methods Forty-eight CHF patients with NYHA class Ⅱ and Ⅲ clinical features were divided into two groups according to their cardiac function classification: 25 patients with cardiac function grade CHF and 23 patients with grade Ⅲ CHF. Every patient was collected about 10 min standard limb lead Ⅱ ECG signal extracted R wave peak position, the structure of the inter-ECG interval. According to the interphase sequence of ECG, a new method of graph analysis of heart rate variability (HRR), normalized histogram of RR interval sequence, quantitative evaluation index of normalized histogram of RR interval sequence, fuzzy interval information entropy. Statistical analysis was used to test the two groups of CHF patients in the index fuzzy interval information entropy on whether there was significant statistical difference. Results Group t test showed significant difference between the two groups (P = 0.001). Conclusions RR interval sequence normalized histogram construction method can be used for clinical CHF patients with cardiac function rating.