摘要
目的:探究心率变异性(HRV)及心电图QT离散度对急性心肌梗死(AMI)心室颤动的预测价值。方法:选取60例在医院就诊的AMI患者,将其纳入AMI组,根据患者住院期间是否发生室颤将其分为室颤组(20例)和非室颤组(40例),再根据心肌梗死部位将60例患者分为前壁心肌梗死组(31例)和非前壁心肌梗死组(29例);另选取58名同期健康体检者纳入健康对照组。分别比较健康对照组与AMI组、室颤组与非室颤组以及前壁心肌梗死组与非前壁心肌梗死组的HRV、心电图正常R-R间期的标准差(SDNN)、低频成分(LF)、高频成分(HF)和QT变异性(QTV)指标。分析HRV指标对AMI室颤的预测价值。结果:AMI组患者心电图SDNN、LF、HF及QTV显著降低于健康对照组,差异有统计学意义(t=24.141,t=11.334,t=10.388,t=8.074;P<0.05);两组LF/HF比值差异无统计学意义。室颤组与非室颤组患者相比,室颤组患者SDNN、LF、HF及QTV显著降低,LF/HF比值显著增高,差异有统计学意义(t=13.462,t=6.699,t=5.451,t=3.311,t=8.347;P<0.05)。前壁心肌梗死组患者SDNN、LF、HF及QTV均明显低于非前壁心肌梗死组,差异有统计学意义(t=3.175,t=3.757,t=3.034,t=3.069;P<0.05),LF/HF比值大于非前壁心肌梗死组,但差异无统计学意义。结论:AMI患者心电图SDNN、LF/HF及QTV的变化与心室颤动的发生及梗死部位有关,对于预测室颤具有很好的特异性、敏感性及预测价值,并对心室颤动的发生及梗死部位有一定预测价值。
Objective:To explore the predictive value of heart rate variability(HRV) and electrocardiography(ECG) QT variation on ventricular fibrillation of acute myocardial infarction(AMI).Methods:60 patients with AMI who admitted to hospital were selected and divided into AMI group.And they were further divided into the ventricular fibrillation group(n=20) and the non-ventricular fibrillation group(n=40) according to the occurrence of ventricular fibrillation during hospitalization.According to the location of myocardial infarction,these patients also were divided into anterior wall myocardial infarction group(n=31) and non-anterior wall myocardial infarction group(n=29).58 healthy persons who were confirmed by physical examination in the same period were divided into health control group.And the series of indexes included HRV,standard deviation of NN intervals(SDNN),line feed(LF),high feed(HF) and QT variance(QTV) between health control group and AMI group,and between ventricular fibrillation group and non-ventricular fibrillation group,and between anterior wall myocardial infarction group and non-anterior wall myocardial infarction group were compared.And then,the predictive value of HRV for AMI ventricular fibrillation was analyzed.Results:The SDNN,LF,HF,QTV of AMI group were significantly lower than those of health control group(t=24.141,t=11.334,t=10.388,t=8.074,P<0.05),while the difference of the ratio(LF/HF) between the two groups were no significant.Compared with non-ventricular fibrillation group,the SDNN,LF,HF,QTV of fibrillation group were significantly low,while the ratio(LF/HF) of this group was significantly high(t=13.462,t=6.699,t=5.451,t=3.311,t=8.347,P<0.05).The SDNN,LF,HF and QTV of anterior wall myocardial infarction group were significantly lower than those of non-anterior wall myocardial infarction group(t=3.175,t=3.757,t=3.034,t=3.069,P<0.05).And the ratio of LF/HF of anterior wall myocardial infarction group was larger than that of non-anterior wall myocardial infarction group,while the difference of that between the two groups was no significant.Conclusion:The changes of SDNN,LF/HF and QTV in the ECG are related to the occurrence of ventricular fibrillation and the location of infarction in patients with AMI.And it has favorable specificity,sensitivity and predictive value in predicting the occurrence of ventricular fibrillation,and it also has the predictive value for the occurrence of ventricular fibrillation and the location of infarction.
作者
王蕾蕾
韩蓉
付桂芬
WANG Lei-lei;HAN Rong;FU Gui-fen(Room of Electrocardiography,Bayannul Hospital,Bayannul 015000,China)
出处
《中国医学装备》
2020年第7期83-86,共4页
China Medical Equipment
关键词
心肌梗死
心室颤动
心率变异(HRV)
QT间期
Myocardial infarction
Ventricular fibrillation
Heart rate variability(HRV)
QT interval
