摘要
目的 了解急性心肌梗塞 (AMI)心率变异性 (HRV)的演变特点及其在阵发性室性心动过速 (PVT)时的变化。方法 对 6 0例AMI患者和 76名健康成人行 2 4hHRV(时域、频域、散点图 )分析 ;根据AMI后HRV检测先后和合并PVT与否进行分组对比研究 ;并对 12例随访AMI患者的HRV行自身对比研究。结果 AMI患者HRV多数指标显著低于对照组 (P <0 .0 5 ) ,其彗星型散点图比例较对照组亦显著降低 (P <0 .0 1)。AMI后早期(<2 4h )SDNN、SDANN、SDNNindex、三角指数、ULF即显著降低 ,并与TP、VLF、LF一同呈现先降低后不全恢复态势 ,其测值以 2 4h～ 7d时段或 7d～ 2 1d时段为最低 ;其它指标呈降低趋势。HRV多数指标在 4个不同检测时间段的差异无统计学意义。 12例AMI患者HRV指标复测时绝大多数较初测时有不同程度提高 ,SDNN呈显著升高(P <0 .0 1)。合并短阵室速和心肌缺血者除SDNN、SDANN外其它指标测值在分组比较中均相比为最低 ,但无统计学显著意义 (P >0 .0 5 )。结论 AMI患者HRV显著低于正常对照组 ,且随时间推移呈逐步恢复的演变 ,表明AMI患者自主神经受损。
Objective To observe the feature of heart rate variability (HRV) in patients with acute myocardial infarction (AMI) and observe the change of HRV in patients with AMI and paroxysmal ventricular tachycardia (PVT). Methods Sixty patients with AMI and 76 healthy adults were measured with 24-hour-long time domain analysis methods、24-hour-long frequency domain analysis methods and 24-hour-long nonlinear methods. Patients were divided into several groups and studied respectively, according to the duration to HRV and whether it coexisted with PVT or not after AMI.Twelve patients whose HRV had been re-examined were contrasted and studied with themselves. Results Most of patients' HRV indexes were apparently lower than that of healthy adults( P <0.05) and their proportion of comet shape plots decreased obviously too after AMI( P <0.01). SDNN、SDANN、SDNNindex、triangular、ULF immediately decreased after AMI(<24h ), SDNN、SDANN、SDNNindex、triangular、ULF、TP、VLF、LF decreased to the least level in 24h～7d or in 7d～21d after AMI and recovered progressively soon afterwards. NN50、PNN50、RMSSD、SDSD、HF declined to lower level. Most of HRV indexes did not show apparent difference in the different period after AMI. HRV indexes of 12 patients from the first examination(93.958±149.777h) were almost higher than that from the second examination(84.958±106.751d) unevenly and SDNN apparently increased( P <0.01). Except SDNN、SDANN, other indexes of patients with PVT and active myocardial ischemia were in lower level than those in other observed groups. Conclusions The HRV of patients with AMI is apparently lower than that in normal persons and develops regularly in the process of time. There is more decrease in HRV in patients with PVT and active myocardial ischemia after AMI.
出处
《苏州医学院学报》
2001年第1期48-50,58,共4页
Acta Academiae Medicinae Suzhou
