摘要
【目的】探讨心率变异性(HRV)指标对急性冠脉综合征(ACS)患者经皮冠状动脉介入治疗(PCI)术后短期预后的预测价值。【方法】选取2022年3月至2024年5月在本院行PCI的157例ACS患者,所有患者均口服阿托伐他汀钙片,根据治疗后6个月内是否发生主要不良心血管事件(MACE)将患者分为对照组(未出现MACE,n=125)和观察组(出现MACE,n=32)。比较两组治疗前后的HRV指标[正常心搏之间的间隔(NN间期)的标准差(SDNN)、NN间期差的均方根(rMSSD)、低频(LF)、高频(HF)、近似熵(ApEn)和样本熵(SampEn)、SD1、SD2]、24 h动态心电图指标[震荡斜率(TS)、震荡初始(TO)、24 h QT间期变异性(24hQTV)、24 h连续5 min正常R-R间期标准差(SDANN-index)]、Gensini评分,采用Pearson相关性分析Gensini评分与HRV指标相关性,多因素Logistic回归分析ACS患者发生MACE的危险因素。【结果】观察组SDNN、LF、SD2、Gensini评分高于对照组,rMSSD、HF、SD1低于对照组,差异有统计学意义(P<0.05)。观察组TS、24hQTV、SDANN-index低于对照组,TO高于对照组,差异均有统计学意义(P<0.05)。Pearson相关性分析显示,Gensini评分与SDNN、LF、SD2呈正相关(r=0.266、0.232、0.258,均P<0.05),与rMSSD、HF、SD1呈负相关(r=-0.218、-0.181、-0.242,均P<0.05)。多因素Logistic回归分析显示,SDNN、LF、SD2与ACS患者PCI术后发生MACE呈正相关(P<0.05),而TS、rMSSD、HF、SD1、24hQTV、SDANN-index与ACS患者PCI术后发生MACE呈负相关(P<0.05)。【结论】HRV对ACS患者PCI术后短期预后的预测价值较高,其在评估患者病情严重程度和治疗效果方面具有重要价值。
【Objective】To explore the changes of heart rate variability(HRV)indicators in patients with acute coronary syndrome(ACS)after percutaneous coronary intervention(PCI)treated with oral atorvastatin calcium tablets,and to evaluate the predictive value of HRV indicators in short-term prognosis.【Methods】A total of 157 ACS patients who underwent PCI in our hospital from March 2022 to May 2024 were selected.All patients took atorvastatin calcium tablets orally.According to whether major adverse cardiovascular events(MACE)occurred within 6 months after treatment,the patients were divided into a control group(no MACE occurred,n=125)and an observation group(MACE occurred,n=32).HRV indicators[standard deviation of normal-to-normal intervals(SDNN),root mean square of the differences between successive normal-to-normal intervals(rMSSD),low frequency(LF),high frequency(HF),approximate entropy(ApEn),sample entropy(SampEn),SD1,SD2]before and after treatment,24-hour dynamic electrocardiogram indicators[turbulence slope(TS),turbulence onset(TO),24-hour QT interval variability(24hQTV),standard deviation of the average normal R-R intervals for successive 5-minute segments(SDANN-index)],and Gensini score were compared between the two groups.Pearson correlation analysis was used to analyze the correlation between Gensini score and HRV indicators,and multivariate Logistic regression analysis was used to analyze the risk factors for MACE in ACS patients.【Results】The SDNN,LF,SD2 and Gensini scores in the observation group were higher than those in the control group,while rMSSD,HF and SD1 were lower than those in the control group,with statistically significant differences(P<0.05).The TS,24hQTV and SDANN-index in the observation group were lower than those in the control group,and TO was higher than that in the control group,with statistically significant differences(P<0.05).Pearson correlation analysis showed that Gensini score was positively correlated with SDNN,LF and SD2(r=0.266,0.232,0.258,all P<0.05),and negatively correlated with rMSSD,HF and SD1(r=-0.218,-0.181,-0.242,all P<0.05).Multivariate Logistic regression analysis showed that SDNN,LF and SD2 were positively correlated with the risk of MACE in ACS patients(P<0.05),while rMSSD,HF,SD1,24hQTV and SDANN-index were negatively correlated with the risk of MACE(P<0.05).【Conclusion】HRV has high value in predicting the short-term prognosis of ACS patients after PCI,and it plays an important role in evaluating the severity of patients'condition and treatment effect.
作者
夏益兰
杨为亚
孙玲
XIA Yilan;YANG Weiya;SUN Ling(Funing People's Hospital,Yancheng Jiangsu 224400)
出处
《医学临床研究》
2026年第3期387-390,共4页
Journal of Clinical Research
关键词
冠状动脉疾病
急性病
综合征
经皮冠状动脉介入治疗
心率
Coronary Artery Disease
Acute Disease
Syndrome
Percutaneous Coronary Intervention
Heart Rate
