静息心率与急性心肌梗死关系的临床探讨  

Clinical analysis of the correlation of resting heart rate and acute myocardial infarction

作　　者：王淑斐[1] 许金成[2] 陈紫平[1] 彭向琼[1] 黄婷[1] 彭秀慈[1] 

机构地区：[1]南方医科大学附属深圳宝安医院体检中心,广东深圳518101 [2]南方医科大学附属深圳宝安医院心内科,广东深圳518101

出　　处：《中国心脏起搏与心电生理杂志》2008年第3期232-234,共3页Chinese Journal of Cardiac Pacing and Electrophysiology

摘　　要：目的探讨静息心率(RHR)在急性心肌梗死(AMI)中的变化及临床意义。方法选择住院确诊的AMI患者110例进行RHR测定,以40例体检无异常发现者作为对照,分析RHR与AMI的梗死面积、并发症及预后之间的关系。结果AMI组RHR显著高于正常人(82.8±12.4次/分vs71.8±10.4次/分,P<0.001);不同梗死面积的患者间RHR差异显著(F=6.393,P<0.01),RHR随梗死面积的增加而增快;合并心力衰竭或休克的AMI患者RHR显著高于无合并症者(P<0.05或0.001);RHR增快(≥80次/分)的AMI患者射血分数低于RHR正常(<80次/分)者(P<0.01);住院期间死亡患者RHR亦显著高于病情好转及治愈者(t=3.995,P<0.001),其中RHR≥90次/分的AMI患者的住院病死率显著高于RHR<90次/分的AMI患者(χ2=25.521,P<0.005)。结论RHR与AMI的发生与发展有一定关系,可作为评估AMI病情和预后的指标之一。Objective To study changes and significance of resting heart rate （RHR） in patients with acute myocardial infarction （AMI）. Methods 110 patients with AMI who were in hospital and 40 healthy people were examined RHR. The relationship between RHR and the proportion of infarct, complication and prognosis of AMI were analyzed. Result RHR in AMI group was significantly higher than that in normal group （82.8±12.4 bpm vs 71.8±10.4 bpm, P 〈0.001 ）. RHR in different proportion of infarct of AMI was significantly different （P 〈 0.01, respectively）, and increased with the augment of the proportion of infarct . RHR in AMI patients complicated with heart failure or shock was higher than those with no complication （P 〈0.05 or 0.001 ）. The ejection fraction in patients whose RHR was rapid（ 〉180 bpm） was lower compared with those RHR was normal （ 〈 80 bpm） （ P 〈 0.01 ）. RHR in AMI patients who died in hospital increased significantly compared with those survived （ P 〈 0.001 ） , and the mortality of AMI patients whose RHR 〉1 90 bpm was significantly higher than those RHR 〈 90 bpm （P 〈 0. 005 ）. Conclusion RHR is related to the development and prognoses of AMI, and it may be one of the guidelines to estimate the state of AMI and prognosis.

关 键 词：心血管病学 静息心率 急性心肌梗死 临床 预后 

分 类 号：R542.22[医药卫生—心血管疾病] R540.41[医药卫生—内科学]