Assessment Value of Heart Rate Variability on Prognosis of Patients with Subarachnoid Hemorrhage and Delayed Cerebral Ische-mia

CHEN Gui-fa; GU Xin

doi:10.3969/j.issn.1004-5775.2015.03.007

Abstract：Objective To investigate the assessment value of heart rate variability on prognosis of patients with subarachnoid hemor-rhageanddelayedcerebralischemia(DCI).Methods 160patientswithsubarachnoidhemorrhageinthehospitalfromFebruary,2010to February, 2013 were selected and divided into the DCI group (n=42) and the non-DCI group (n=118) according to the occurrence of DCI.Two groups were treated with conventional treatment and adopted 2 years′follow-up.HRV and Glasgow score ( GCS) and two years′survival rates, mortality and prognosis of the two groups before and after treatment were statistically analyzed.Relationship between GCS and HRV in patients with SAH and DCI were analyzed and risk factors for poor prognosis of patients with SAH and DCI were analyzed by Logis-tic analysis.Results GCS, SDNN, SDANN, rMSSD, PNN50, HF and LF and other HRV indexes of DCI group before treatment are lower than that of the non-DCI group.GCS and HRV indexes of the two groups after treatment are improved, and GCS and HRV indexes of DCI group are higher than that of the non-DCI group.The difference is statistically significant (P<0.05).Cure rate and 2 years′survival rate of DCI group are significantly lower than that of non-DCI group, while fatality rate, concurrent cerebral infarction rate and hemorrhage re-occurrence rate of DCI group are significantly higher than of non-DCI group (P<0.01).Pearson correlation analysis results show that age, mean arterial pressure(MAP), SDNN, SDANN, rMSSD, PNN50, HF and LF are negatively correlated with GCS (r=-0.635,-0.725,-0.559, -0.621, -0.543, -0.582, -0.615 and -0.658, P<0.05).Logistic regression analysis results show that risk factors for poor prognosis of patients with SAH and DCI are MAP, SDNN, SDANN, rMSSD, PNN50, HF and LF (P<0.05).Conclusion HRV of SAH patients with DCI reduces and HRV is related with the prognosis of patients, therefore reducing indexes of HRV can be used to predict poor prognosis of patients with SAH and DCI.