急性心肌梗死后心率变异性和心源性猝死危险性的关系

摘要

Objective:To investigate the relationship between heart rate variability ( HRV) changes and sudden cardiac death of acute myocardial infarction ( AMI) .Methods:From May 2002 to December 2012 , 100 cases of AMI died of sudden cardiac after admitted to our hospital , and 100 cases of healthy subjects were selected.left ventricular ejection fraction (LVEF), electrocardiogram QRS duration, QT interval, cor-rected QT interval ( QTc ) were retrospectively analyzed; And then 50 patients with high-risk of sudden death, and 50 cases of low-risk patients from May 2011 to January 2013 were selected, and SDNN, SDANN, rMSSD, PNN50, LF, HF, TF, LF /HF and other indicators were statistically analyzed.Results:QRS, QT, QTc values of SCD group was higher than those in control group, LVEF was lower than that in the control group, and the difference was statistically significant ( P <0.05 ); SDNN, SDANN, rMSSD, PNN50, LF, HF, TF, LF /HF of high-risk group were lower than those in low-risk group , all indicators were statistically significant ( P<0 .05 or 0 .01 ,0 .0001 ) .Conclusion:The HRV in acute phase of AMI de-crease significantly , which suggesting that early detection of HRV after AMI indicators can predict the occur-rence of sudden cardiac death.%目的：探讨急性心肌梗死（ AMI）患者心率变异性（ HRV）变化与猝死的关系。方法：选择我院2002年5月至2012年12月收治入院的AMI后心源性猝死（ SCD ）死亡患者100例和健康体检者100例，对其超声左室射血分数（ LVEF），心电图QRS宽度、QT间期、校正QT间期（ QTc）进行回顾性分析；另对2011年5月至2013年1月收治入院的被列入猝死高危范围心脏病患者50例和低危患者50例，并对SDNN、SDANN、rMSSD、PNN50、LF、HF、TF、LF/HF等指标进行统计学分析。结果：SCD组QRS、QT、QTc值高于对照组，而SCD组LVEF值低于对照组，且两组比较差异有统计学意义（ P＜0．05）；高危组的SDNN、SDANN、rMSSD、PNN50、LF、HF、TF、LF/HF均低于低危组，所有指标均有统计学意义（P＜0．05或0．01、0．0001）。结论：AMI急性期HRV明显下降，提示早期检测AMI后的HRV指标可预测心源性猝死的发生。