CAJ | 학술논문

目的：探讨心率减速力对急性心肌梗死患者的预警价值。方法选取200例发病≤两周的急性心肌梗死后窦性心律的患者为 AMI 组和200例非急性心肌梗死患者为非 AMI组，对两组均记录24 h 动态心电图，获取心率减速力值和心率加速力值，并进行预警分析。结果AMI 组一支病变52例，两支病变98例，三支病变50例；非 AMI 组一支病变98例，两支病变68例，三支病变34例。AMI 组一年病死率：心率减速力值≥4．5 ms 为2．00％，2．6～4．4 ms为7．50％，≤2．5 ms 为10．05％，差异有统计学意义（P ＜0．01）；非急性心肌梗死组心率减速力各值中均无死亡病例。心率加速力值≤－7．0 ms，除 AMI 组一年病死率为1．00％外，余均无死亡病例。结论通过测定心率减速力值，能定量、单独分析和评估迷走神经作用的强度，对 AMI 猝死高危人群筛选与预警有较强的实用价值。
목적：탐토심솔감속력대급성심기경사환자적예경개치。방법선취200례발병≤량주적급성심기경사후두성심률적환자위 AMI 조화200례비급성심기경사환자위비 AMI조，대량조균기록24 h 동태심전도，획취심솔감속력치화심솔가속력치，병진행예경분석。결과AMI 조일지병변52례，량지병변98례，삼지병변50례；비 AMI 조일지병변98례，량지병변68례，삼지병변34례。AMI 조일년병사솔：심솔감속력치≥4．5 ms 위2．00％，2．6～4．4 ms위7．50％，≤2．5 ms 위10．05％，차이유통계학의의（P ＜0．01）；비급성심기경사조심솔감속력각치중균무사망병례。심솔가속력치≤－7．0 ms，제 AMI 조일년병사솔위1．00％외，여균무사망병례。결론통과측정심솔감속력치，능정량、단독분석화평고미주신경작용적강도，대 AMI 졸사고위인군사선여예경유교강적실용개치。
Objective To explore the significance of deceleration capacity of rate(DC)in early warning of acute myocardial infarction(AMI).Methods In our study,200 patients were enrolled in AMI group who were attacked by AMI two weeks ago at most and restored sinus rhythm after-wards.Another 200 cases without AMI were divided into non-AMI group.All the candidates under-went 24-hour ambulatory electrocardiography.Their values of DC and acceleration capacity of rate (AC)were recorded and made early warning analysis.Results In AMI group,single-vessel dis-ease was found in 52 cases,two-vessel disease in 98 and triple-vessel disease in 50 while the num-bers were 98,68,and 34,respectively in non-AMI group.For patients in AMI group,the mortality in one year was as follows:2.00% if DC≥4.5 ms;7.50% if DC was 2.6 -4.4 ms;1 0.05% if DC≤2.5 m,with statistically significant differences(P <0.01 ).No death was reported in non-AMI group,with variation of DC values.AC≤ -7.0 ms,and no death was reported except for a mortality in one year of 1 .00% in AMI group.Conclusion DC determination can quantitively analyze and measure the intensity of vagus nerve effect all alone,which proves to be significantly practical in screening and making early warning of AMI patients at high risk from sudden death.