子宫内膜癌(EC)的发病率在全球范围内呈上升趋势,但EC凝血功能障碍的具体机制尚不完全清楚。本研究的目的是通过心率变异性(HRV)分析探讨EC患者自主神经系统功能与凝血功能之间的关系。该研究包括在蚌埠医科大学第一附属医院妇科肿瘤科(蚌埠,中国)从2021年12月到2023年3月。收集每位患者的5分钟静息心电图以分析HRV参数,包括正常-正常间隔的时域参数标准差(SDNN)和连续间隔差的均方根(RMSSD),和频域参数低频功率和高频功率(HF)。血液样本接受生化测试以测量凝血标志物,即凝血酶原时间(PT),国际标准化PT比率(PT-INR),凝血酶原活性(PTA),活化部分凝血活酶时间(APTT)和纤维蛋白原。双变量Spearman相关分析显示,PT,PT-INR和APTT与SDNN呈显著正相关,RMSSD和HF,PTA与RMSSD呈显著负相关。在对混杂因素进行调整后,即年龄,身体质量指数,更年期,输卵管结扎,糖尿病,高血压,辅助化疗和平均心率,线性回归分析表明,SDNN,RMSSD和HF是影响EC患者PT和PT-INR的独立因素。本研究的结果表明,某些HRV参数与EC中的凝血标志物相关,并为癌症相关凝血功能障碍的发生提供了新的见解。
The incidence of endometrial cancer (EC) is increasing worldwide, but the specific mechanism of coagulation dysfunction in EC is not fully understood. The objective of the present study was to explore the relationship between autonomic nervous system function and coagulation function in patients with EC using heart rate variability (HRV) analysis. The study included 100 patients with EC who were treated at the Department of Gynecological Oncology of The First Affiliated Hospital of Bengbu Medical University (Bengbu,
China) from December 2021 to March 2023. A 5-min resting electrocardiogram was collected from each patient to analyze HRV parameters, including the time domain parameters standard deviation of the normal-normal intervals (SDNN) and root mean square of successive interval differences (RMSSD), and the frequency domain parameters low-frequency power and high-frequency power (HF). Blood samples were submitted to biochemistry tests to measure coagulation markers, namely prothrombin time (PT), international normalized ratio of PT (PT-INR), prothrombin activity (PTA), activated partial thromboplastin time (APTT) and fibrinogen. Bivariate Spearman correlation analyses revealed that PT, PT-INR and APTT were significantly positively correlated with SDNN, RMSSD and HF, while PTA was significantly negatively correlated with RMSSD. Following adjustments for confounding factors, namely age, body mass index, menopause, ligation of the fallopian tubes, diabetes, hypertension, adjuvant chemotherapy and mean heart rate, linear regression analysis demonstrated that SDNN, RMSSD and HF were independent factors influencing PT and PT-INR in patients with EC. The findings of the present study indicate that certain HRV parameters correlate with coagulation markers in EC and provide new insight into the occurrence of cancer-associated coagulation dysfunction.