江苏实用心电学杂志
江囌實用心電學雜誌
강소실용심전학잡지
JOURNAL OF PRACTICAL ELECTROCARDIOLOGYJS
2014年
3期
167-169,173
,共4页
何文一%邓国兰%王玲莉%宋瑾%侯佳宏
何文一%鄧國蘭%王玲莉%宋瑾%侯佳宏
하문일%산국란%왕령리%송근%후가굉
急性心肌梗死%连续心率减速力%危险分层%左室射血分数%心率变异性%冠状动脉病变
急性心肌梗死%連續心率減速力%危險分層%左室射血分數%心率變異性%冠狀動脈病變
급성심기경사%련속심솔감속력%위험분층%좌실사혈분수%심솔변이성%관상동맥병변
acute myocardial infarction%heart rate deceleration runs%risk stratification%left ventricular ejection fraction%heart rate variability%coronary artery disease
目的:探讨急性心肌梗死患者的连续心率减速力(heart rate deceleration runs,DRs)危险分层与心率减速力(deceleration capacity,DC)、心率变异性总标准差(SDNN)、左室射血分数(left ventricular ejection fraction,LVEF)以及冠状动脉狭窄程度之间的关系。方法38例急性心肌梗死患者和20例体检者接受24 h动态心电图和超声心动图检查,测定其DC值、DRs、HRV时域指标SDNN以及LVEF;对急性心肌梗死患者进行冠状动脉造影,记录冠脉狭窄程度。按照DRs结果分为低危组(17例)、中危组(15例)、高危组(6例)、对照组(20例),比较4组间年龄、DC值、SDNN、LVEF及冠脉狭窄程度。结果①高危组的年龄比低危组明显增大,差异有统计学意义(P<0.05);②从对照组到高危组,DC值和SDNN值逐渐降低,高危组与其他3组相比明显降低,其差异有统计学意义(P<0.05);③DRs分层与冠脉狭窄程度无明显相关性。结论急性心肌梗死患者DRs分层和DC值、SDNN间有显著相关性,均能评估急性心肌梗死患者迷走神经张力,联合应用可提高心肌梗死后猝死的预警。
目的:探討急性心肌梗死患者的連續心率減速力(heart rate deceleration runs,DRs)危險分層與心率減速力(deceleration capacity,DC)、心率變異性總標準差(SDNN)、左室射血分數(left ventricular ejection fraction,LVEF)以及冠狀動脈狹窄程度之間的關繫。方法38例急性心肌梗死患者和20例體檢者接受24 h動態心電圖和超聲心動圖檢查,測定其DC值、DRs、HRV時域指標SDNN以及LVEF;對急性心肌梗死患者進行冠狀動脈造影,記錄冠脈狹窄程度。按照DRs結果分為低危組(17例)、中危組(15例)、高危組(6例)、對照組(20例),比較4組間年齡、DC值、SDNN、LVEF及冠脈狹窄程度。結果①高危組的年齡比低危組明顯增大,差異有統計學意義(P<0.05);②從對照組到高危組,DC值和SDNN值逐漸降低,高危組與其他3組相比明顯降低,其差異有統計學意義(P<0.05);③DRs分層與冠脈狹窄程度無明顯相關性。結論急性心肌梗死患者DRs分層和DC值、SDNN間有顯著相關性,均能評估急性心肌梗死患者迷走神經張力,聯閤應用可提高心肌梗死後猝死的預警。
목적:탐토급성심기경사환자적련속심솔감속력(heart rate deceleration runs,DRs)위험분층여심솔감속력(deceleration capacity,DC)、심솔변이성총표준차(SDNN)、좌실사혈분수(left ventricular ejection fraction,LVEF)이급관상동맥협착정도지간적관계。방법38례급성심기경사환자화20례체검자접수24 h동태심전도화초성심동도검사,측정기DC치、DRs、HRV시역지표SDNN이급LVEF;대급성심기경사환자진행관상동맥조영,기록관맥협착정도。안조DRs결과분위저위조(17례)、중위조(15례)、고위조(6례)、대조조(20례),비교4조간년령、DC치、SDNN、LVEF급관맥협착정도。결과①고위조적년령비저위조명현증대,차이유통계학의의(P<0.05);②종대조조도고위조,DC치화SDNN치축점강저,고위조여기타3조상비명현강저,기차이유통계학의의(P<0.05);③DRs분층여관맥협착정도무명현상관성。결론급성심기경사환자DRs분층화DC치、SDNN간유현저상관성,균능평고급성심기경사환자미주신경장력,연합응용가제고심기경사후졸사적예경。
Objective To investigate the relationship between risk stratification of heart rate de-celeration runs(DRs)and deceleration capacity(DC),standard diviation of NN intervals(SDNN), left ventricular ejection fraction(LVEF)as well as severity of coronary artery stenosis in patients with acute myocardial infarction(AMI).Methods Thirty-eight cases with AMI and 20 healthy sub-jects underwent 24-hour ambulatory electrocardiography and echocardiogram examinations while their DC values,DRs,HRV time domain indexes of SDNN and LVEF were measured.Coronary angiog-raphy was carried out on AMI patients to record the degree of coronary artery stenosis.According to the results of DRs,all of the enrolled subjects were divided into low-risk group(17 cases),medium-risk group(15 cases),high-risk group (6 cases)and control group (20 cases).Amongst the 4 groups,ages,DC values,SDNN,LVEF and degree of coronary artery stenosis were compared.Re-sults ① Compared with low-risk group,there was a significant rise of ages in high-risk group with statistically significant difference(P<0.05).②From control group to high-risk group,values of DC and SDNN decreased gradually.The two indexes significantly reduced in high-risk group if compared with the other 3 groups,with statistically significant difference(P<0.05).③ There was no obvious correlation between risk stratification of DRs and degree of coronary artery stenosis.Conclusion For AMI patients,the risk stratification of DRs and DC,SDNN are significantly correlated,all of which can evaluate vagus tension of AMI patients and a combination of which can improve early warning of sudden death after myocardial infarction.