急性心肌梗死后心率变异演变和恢复及其相关因素的实验研究  

Experimental Study on the Correlation of Evolution and Recovery of Heart Rate Variability After Acute Myocardial Infarction

作　　者：唐丽萍[1] 庄亚纯[1] 刘忠豫[1] 田静[1] 庄文燕[1] 顾菊康[1] 郑明芳[1] 许群[1] 沈仲元[2] 

机构地区：[1]上海市第一人民医院心内科 [2]上海中医药大学

出　　处：《中国心脏起搏与心电生理杂志》1999年第4期227-229,共3页Chinese Journal of Cardiac Pacing and Electrophysiology

基　　金：国家自然科学基金!39770707

摘　　要：为了解急性心肌梗死（AMI）后心率变异（HRV）的演变情况以及其与心脏组织结构改变之间的关系。采用闭胸式微珠法建立14条犬AMI模型。追踪存活7条犬心肌梗死（MI）后1周、2周HRV动态变化，并与AMI前14条健康犬相对照。处死犬后列检阻塞血管部位并称重坏死心肌。结果：MI后1周HRV时域、频域所有指标较健康犬MI前明显减低（P均＜0．05），MI后2周部分指标（SDNNin，rMSSD，PNN50，ULF，VLF）较1周前有所恢复，但无统计学意义（P＞0．05）。MI1周时HRV各指标与MI部位无关，而与MI范围相关，尤以SDANN，ULF显著（r分别为0．87，0．90，P均＜0．05）。至2周时，HRV则转变为与MI范围无关，而与MI部位有关，以PNNS50有统计学意义（r为0．88，P＜0．05）。结论：MI急性期HRV变化与MI范围的关系提示急性缺血及缺血程度可能与MI后HRV的下降有关。而HRV的远期恢复则与再灌注改善以及MI周围组织水肿、缺氧、代谢的改善有关。To directly observe evolution and recovery of heart rate variability (HRV) after acute myocardial infarction (AMI),and its correlation with the changes in tissue structure of heart. 14 dog models of AMl were established by using very small items in the closed breast. After myocardial infarction, 7 survived dogs were studied about the changes of HRV dynamically on the seventh and fourteenth days,comparing with that of 14 the same dogs before myocardial infaction (MI).The blocked artery was dissected and examined,and the damaged myocardium is weighed after killing the dog. In the first week after MI,the HRV changes of MI group obviously reduced comparing with those of contrast group (P＜0.05 ).In the second week SDNNin,rMSSD, PNN50,ULF and VLF recovered to some extent compnring with those of the first week (P＞0. 05). HRV was correlated to MI range,with the significant correlation of SSANN and ULF (r=0.87, 0. 90 respectively, P＜0. 05), and it had nothing to do with MI location in the first week after MI. lnstead of being correlated to MI range,HRV was correlated to MI location,with statistical meaning of PNN50 (r= O. 88,P＜0. 05) in the second week after MI. Conclusions:Both acute ischemia and its level are likely to be correlated to the decline of HRV after AMl. The recovery of HRV is correlated to the betterment of reperfusion,edema of peripheral tissue,hydrogen supply improvement and development of metabolism.

关 键 词：心肌梗死 心率变异 AMI 相关性因素 

分 类 号：R542.22[医药卫生—心血管疾病]