窦性心率震荡在不同罪犯血管急性心肌梗死后恶性心律失常中的作用

摘要

Objective To explore the difference and clinical significance of heart rate turbulence in acute myocardial infarction (ACI) by different culprit vessels. Methods 87 patients with ACI from March 2014 to November in our hospital were selected as the research object.All patients were provided with electrocardiogram monitoring,dynamic electrocardiogram examination,turbulence onset (TO) before surgery,and were all finished with coronary angiogram and percutaneous coronary intervention (PCI) in order to pick out the culprit vessels including coronary artery lesions in 29 cases,anterior descending branch lesions in 30 cases,and circumflex branch lesions in 28 cases.The TO value and the incidence of malignant arrhythmia among 3 groups was compared. Results The TO value and the incidence rate of arrhythmia in the acute myocardial infarction group with right coronary artery lesion was higher than that in the anterior descending branch of acute myocardial infarction group and the acute myocardial infarction group with cyclotron branch lesion,with significant difference (P<0.05). Conclusion In ACI by different culprit vessels,the probability of TO is different and display certain difference.In ACI induced by right coronary artery,TO’s specificity is high on prediction of adverse events.%目的：探讨窦性心率震荡在不同罪犯血管急性心肌梗死中的区别及临床意义。方法选取2014年3~11月本院心内科收治的87例急性心肌梗死患者作为研究对象,入院后术前均行心电监测、动态心电图检查,检测震荡初始(TO)并给予冠脉造影并PCI,选出罪犯血管为右冠脉病变29例,前降支病变30例,回旋支病变28例。比较3组的TO值及恶性心律失常发生率。结果右冠脉病变急性心肌梗死组的TO值及心律失常发生率显著高于前降支病变急性心肌梗死组和回旋支病变急性心肌梗死组,差异有统计学意义(P<0.05)。结论 TO在急性心肌梗死不同罪犯血管病变中的概率不同,且有一定差异性。其在右冠脉病变血管导致急性心肌梗死中预测恶性事件的特异性较高。