Association Between Pre-operative Heart Rate Variability And Post-operative Inflammatory Markers And Coagulation Indexes In Patients With Cervical Cancer

Objective:Blood inflammatory biomarkers and coagulation indexes,such as peripheral blood neutrophil / lymphocyte ratio（NLR）,lymphocyte /monocyte ratio（LMR）,platelet / lymphocyte ratio（PLR）,C-reactive protein（CRP）,activated partial thrombin time（APTT）,thrombin time（TT）,prothrombin time（PT）,fibrinogen（FIB）and so on,play an important role in predicting the prognosis of cancer.At the same time,studies have shown that there is a certain correlation between cardiac autonomic nerve function characterized by heart rate variability（HRV）and inflammatory markers and blood coagulation indexes in cancer patients.The purpose of this study is to determine whether there is a correlation between preoperative HRV parameters and postoperative blood inflammatory markers and blood coagulation indexes in patients with cervical cancer.Methods:A total of 77 patients with cervical cancer treated in the Department of Gynecology and Oncology,the first affiliated Hospital of Bengbu Medical College from November 2020 to April 2021 were selected for this study.The ECG data of the patients one day and five minutes before the operation were collected by a single-lead miniature ECG recorder,and the time domain and frequency domain parameters were analyzed.The blood of median elbow vein was collected in the morning of the second day after operation,and the coagulation indexes were analyzed and obtained,including PT,TT,APTT,FIB,and inflammatory indexes including LMR,NLR,PLR and CRP.The time series of ECG signals were extracted by Pan-Tompkins algorithm and analyzed by time domain parameters and frequency domain parameters.The standard deviation of RR interval（SDNN）,root mean square（RMSSD）,total power（TP）,extremely low frequency power（VLF）,low frequency power（LF）,high frequency power（HF）and ratio of low frequency power to high frequency power（LF/HF）of all sinus beats were analyzed.The correlation between HRV and hematological indexes was further analyzed.Results:Bivariate Person analysis showed that preoperative RMSSD was significantly correlated with postoperative PLR,LMR and NLR,preoperative HF was significantly correlated with PLR,and preoperative LF/HF was correlated with PLR.After the potential confounding factors including age,BMI and HGB were excluded by multiple linear regression analysis,the correlation between preoperative HF,LF/HF and postoperative PLR still existed.Specifically,for each additional logarithmic single bit of HF,the PLR value decreased by 22.1 ±10.3,and for each additional logarithmic unit of LF/HF,the PLR value increased by 24.6 ±10.8.Conclusion:There was a negative correlation between preoperative HF and postoperative PLR,and a positive correlation between LF/HF and postoperative PLR in patients with cervical cancer,and this correlation existed independently.Preoperative autonomic nervous system still has a certain regulatory effect on postoperative inflammation of cervical cancer,and it shows that preoperative HRV can be used to predict postoperative blood inflammatory markers in patients with cervical cancer.