摘要
目的分析急性心肌梗塞（ＡＭＩ）后老年患者心率变异（ＨＲＶ）时域指标，了解ＡＭＩ后ＨＲＶ变化。方法以多单位协作方式对１５７例ＡＭＩ后２周的老年患者行动态心电图检测ＨＲＶ时域法５项指标，并与健康老年组对比分析。数据经ＥｐｉＩｎｆｏ（６．０）统计软件处理。结果①ＡＭＩ患者的正常Ｒ－Ｒ间期标准差（ＳＤＮＮ）、平均值的标准差（ＳＤＡＮＮ）和标准差的平均值（ＳＤＮＮＩｎｄｅｘ）低于对照组（Ｐ＜０．０１），而相邻正常Ｒ－Ｒ间期差值的均方根（ＲＭＳＳＤ）和相邻正常Ｒ－Ｒ差值大于５０ｍｓ记数占总Ｒ－Ｒ间期数的百分比（ＰＮＮ５０）虽低于对照组，但无显著差异（Ｐ＞０．０５）。②ＡＭＩ后ＨＲＶ时域５项指标男、女性别间无显著性差异（Ｐ＞０．０５）。③ＳＤＮＮ、ＳＤＡＮＮ和ＳＤＮＮＩｎ－ｄｅｘ在心肌梗塞各部位间无显著差异（Ｐ＞０．０５），ＲＭＳＳＤ和ＰＮＮ５０前间壁低于下壁心肌梗塞（Ｐ＜０．０５）。结论老年人ＡＭＩ后ＨＲＶ降低。反映交感神经活性的ＳＤＮＮ、ＳＤＡＮＮ和ＳＤＮＮＩｎｄｅｘ和反映迷走神经活性的ＲＭＳＳＤ和ＰＮＮ５０２组指标变化不相同。
Objective Time domain measures of heart rate variability(HRV)were analyzed in order to investigate its changes in elderly patients after acute myocardial infarction (AMI). Methods 157 elderly patients after 2 weeks of AMI were examined with 24 hour ambulatory electrocardiagraphic recordings to get five time domain measures of HRV,and compared with the healthy elderly group.Data of HRV were analyzed with Epi Info(6 0)statistical software. Results 1.Values of standard deviation of all RR intervals (SDNN),standard deviation of the averages of RR intervals in all 5 minute segments of the entire recording(SDANN)and mean of the standard deviations of all RR intervals for 5 minute segments of the entire recording(SDANN Index) in elderly patients with AMI were lower than those of the control group ( P <0 01),but values of the square roots of the mean of the sum of the squares of differences between adjacent RR intervals(RMSSD)and PNN 50 count divided by the total number of all RR intervals(PNN 50 )were not significantly differen between the two groups( P <0 05).2.Values of HRV five time domain measures were not signifcantly different between the male and the female.3.There was no singnificant difference of SDNN,SDANN and SDNN Index among the infarct sites.Values of RMSSD and PNN 50 in anterior infarction were lower than those in inferior infarction ( P <0 05). Conclusions The elderly patients with AMI had lower value of HRV.The changes in the two groups of indices,i.e., SDNN,SDANN and SDNN Index,which reflected sympathetic activity,and RMSSD and PNN 50 ,which reflected parasympathetic activity,were different.
出处
《实用老年医学》
CAS
1998年第1期25-26,共2页
Practical Geriatrics
关键词
心率变异
心肌梗塞
时域指标
老年人
Heart rate variability Myocardial infarction Time domain measure
