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冠状动脉支架植入术对自主神经功能的影响

Effect of percutaneous tranluminal coronary angioplasty and stent implantation on cardiac autonomic nervous function
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摘要 目的观察冠状动脉支架植入术前后24小时心率变异性(HRV)的变化,了解冠状动脉支架植入术对自主神经功能的影响。方法21例患者于冠状动脉支架植入术前记录24小时动态心电图,并于术后1周、1个月及3个月重复检查,分析心率变异性,包括时域分析:24小时内全部窦性RR间期的标准差(SDNN),24小时内每5分钟节段窦性RR间期平均值的标准差(SDANN),24小时内每5分钟节段窦性RR间期标准差的均值(SDNNI);频域分析:总频谱成分(TF),低频成分(LF),高频成分(HF)。结果冠状动脉支架植入术后1周HRV值较术前降低[SDNN(121.1±34.8)ms vs(96.8±40.8)ms,SDANN(105.7±38.9)ms vs(89.3±38.9)ms,SDNNI(51.0±12.6)msvs(40.1±11.8)ms(P<0.05)],即时域指标和频域指标均明显降低[TF(7.11±0.24)ms2/Hz vs(6.43±0.59)ms2/Hz,LF(5.48±0.48)ms2/Hz vs(4.68±0.65)ms2/Hz,HF(5.51±0.82)ms2/Hz vs(4.82±0.81)ms2/Hz)](P<0.05)。术后1、3个月复查,HRV基本恢复至术前水平。结论冠状动脉支架植入术可导致自主神经功能暂时性受损,术后1周内出现的室性心律失常要予以重视。 Objective To determine the influences of percutaneous transluminal coronary angioplasty and stent implantation on heart rate variability(HRV). Methods Three-channel,24-hour ambulatory electrocardiography(ECG) was performed. Time and frequency domain measures of HRV were analyzed from 24-hour ambulatory ECG recordings. Time domain:standard deviation of normal-to-normal interval(SDNN),standard deviation of average normal-to-normal interval(SDANN),standard deviation of normal-to-normal interval index(SDNNI). Frequency domain:total frequency components(TF) ,low frequency components(LF) ,high frequency components(HF). HRV was performed before stent implantation and repeated at a week and 1,3 months after stent implantation. Results Compared with the values of HRV before stent implantation, time domain analysis at one week after stent implantation revealed a significant decrease in SDNN (121.1±34.8) ms vs (96.8±40.8) ms,SDANN (105.7±38.9) ms vs (89.3±38.9) ms, SDNN index (51.0±12.6) ms vs (40.1±11.8) ms ( P .〈0. 05) ; and frequency domain analysis revealed marked attenuation of TF (7. 11±0.24) ms^2/Hz vs (6.43±0.59) ms^2/Hz),LF (5.48±0.48) ms^2/Hz vs (4.68±0.65) ms^2/Hz and HF (5.51±0.82) ms^2/Hz vs (4.82±0.81) ms^2/Hz)( P〈0.05). All the values were improved at one and three months after stent implantation. Conclusion Autonomic nervous system activity may be impaired early after PTCA and stent implantation but could recover.
出处 《临床荟萃》 CAS 北大核心 2006年第9期621-623,共3页 Clinical Focus
关键词 冠状动脉疾病 支架 自主神经系统 coronary diseasel stentsl autonomic nervous system
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参考文献5

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二级参考文献1

  • 1陈灏珠,临床心电图学杂志,1994年,3卷,4期,168页

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