不稳定型心绞痛老年患者经皮冠脉介入治疗前后窦性心率震荡变化的研究  

Sinus heart rate turbulence in the unstable angina in elderly patients before and after percutaneous coronary intervention treatment change

作　　者：陈志刚[1] 姚红波[1] 张跃光[1] 岳兵[1] 李建华[1] 关慧灵[1] 

机构地区：[1]新乡医学院第一附属医院心内科,河南卫辉453100

出　　处：《现代预防医学》2012年第22期6070-6072,6072,共3页Modern Preventive Medicine

摘　　要：目的探讨不稳定型心绞痛(unstable angina pectoris,UA)患者在经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)后自主神经功能改善的情况及其临床意义。方法选择2010年1月～2011年10月在某院心血管内科住院的不稳定型心绞痛患者分为低危组、中危组、高危组各20例(拟行冠状动脉介入治疗),每组同时设置药物对照各20例(各种原因致患者未能进行冠状动脉介入治疗),共120例入选作为研究对象。治疗前及治疗后1个月均行12导联24h动态心电图监测。结果 PCI术后TO值均明显低于各自术前,而TS值显著高于术前,尤其是高危组表现更为明显,差异有统计学意义(P﹤0.05);药物治疗1个月前后中低危组TO、TS均无明显改变(P﹥0.05);高危组药物治疗后TO降低,TS升高,差异有统计学意义(P﹤0.05);PCI组与药物对照组比较,PCI后较药物治疗后各组TO、TS均有明显改善,表现为TO值明显降低,TS值显著升高,差异有统计学意义(P﹤0.05)。结论对UA患者尽早进行介入干预(尤其是对高危者)可有利于改善预后。OBJECTIVE To discuss autonomic function and its clinical significance of unstable angina(unstable angina pectoris,UA)patients in the percutaneous coronary intervention therapy(percutaneous coronary intervention,PCI).METHODS Cardiovascular medicine at our hospital from January 2010 to October 2011 hospitalized patients with unstable angina was divided into low risk group,risk group and high-risk group.20 cases(scheduled for coronary intervention therapy)were in the drug control,each group has 20 cases(for various reasons caused by patients with failed percutaneous coronary intervention).A total of 120 cases were selected in our study.A 12-lead 24-hour Holter Line was used for monitoring before treatment and after treatment.RESULTS PCI postoperative TO values were significantly lower than their respective preoperative TS values significantly higher than that before treatment,especially in high-risk groups,and there was significant difference(P﹤0.05);TO and TS had no significant changes in low-risk group before and after treatment(P﹥0.05);TO was reduced in high-risk group after treatment,and TS was increased,and there was significant difference(P﹤0.05);Comparing the PCI group and drug control group,TO and TS of PCI group showed significant improvement.TO value was significantly decreased,and TS value was significantly increased.T here was significant difference(P﹤0.05).CONCLUSION The early intervention of patients with UA(especially in high-risk)will help to improve the prognosis.

关 键 词：不稳定型心绞痛 窦性心率震荡 经皮冠状动脉介入治疗 

分 类 号：R541.4[医药卫生—心血管疾病]