急性心肌梗死患者的心率变异性特征分析

摘要

目的:探讨急性心肌梗死患者心率变异性(HRV)特征.方法:选择急诊心肌梗死患者190例,根据冠脉狭窄程度积分(Gensini评分)将其分为冠状动脉病变高分组、中分组、低分组.常规检测生化指标,进行24h动态心电监测,记录HRV指标,分析比较各组间HRV指标差异有无统计学意义,同时比较HRV与心肌梗死部位相关性.结果:HRV指标ASDNN、RMSSD、SDNN和SDANN随着Gensini评分值升高而降低,低分组、中分组、高分组组间比较差异具有统计学意义(均P＜0.05);Pearson相关分析显示HRV指标ASDNN、RMSSD、SDNN和SDANN与Gensini评分值呈负相关(P＜0.05).与非前壁心肌梗死相比,前壁心肌梗死患者HRV指标ASDNN、RMSSD、SDANN和SDNN较低,差异有统计学意义(P＜0.05).结论:急性心肌梗死患者HRV各指标与冠状动脉病变程度及心肌梗死部位有相关性.%Objective:To explore features of heart rate variability (HRV) in patients with acute myocardial infarction.Methods:One hundred and ninety patients with myocardial infarction who underwent coronary angiography were analyzed and divided into three groups by Gensini scoring:low group(n=62),middle group(n=64),high group(n =64).All cases underwent 24 hour ambulatory electrocardiogram and their biochemical indicators were detected.Finally,the clinical information was analyzed and compared.Results:ASDNN,RMSSD,SDNN and SDANN indices tended to decrease with the extent and severity of coronary artery lesion,and showed statistical differences among low group,middle group and high group (P＜0.05).The index of HRV decreased as the severity of artery lesion increased (P＜0.05).Anterior wall myocardial infarction had lower HRV in ASDNN,RMSSD SDNN and SDANN indices (all P ＜0.05) than non-anterior wall myocardial infarction.Conclusion:The HRV may be related to the lesion degree of coronary artery and the location of myocardial infarction in patients with acute myocardial infarction.