急性心肌梗死患者植入国产西罗莫司支架后心率震荡的动态分析  

Mid-and long-term effects of domestic produced sirolimus drug-eluting stent on heart rate turbulence in patients with acute myocardial infarction

作　　者：施亚明[1] 孙剑萍[1] 吴春阳[1] 朱士洲[1] 宗永忠[1] 王斌[1] 施国富[1] 

机构地区：[1]盐城市第三人民医院心内科,江苏盐城224001

出　　处：《岭南心血管病杂志》2011年第5期387-389,共3页South China Journal of Cardiovascular Diseases

基　　金：江苏省"六大人才高峰"第四批资助项目(项目编号:07-B-004)

摘　　要：目的探讨急性心肌梗死患者植入国产西罗莫司洗脱支架后心率震荡的动态变化。方法应用动态心电图技术分别记录76例急性心肌梗死患者(支架组)支架植入后24 h内、1周、3个月、6个月、12个月和24个月的心电图信息,计算各时段的震荡起始(TO)和震荡斜率(TS)。并与同期未行再灌注治疗的急性心肌梗死患者53例(对照组)进行对比分析。结果支架组支架植入术后24 h的震荡起始(-0.21%±1.95%vs.0.26%±1.71%,P<0.01)和震荡斜率[(13.73±6.48)ms/RR vs.(1.21±0.53)ms/RR,P<0.01]与对照组心肌梗死后24 h比较,明显改善,差异有统计学意义,并在随后的24个月中保持这种趋势。尽管对照组患者的震荡斜率在3个月后得到改善(P<0.05),但不如支架组改善明显,差异有统计学意义(P<0.05)。结论国产西罗莫司洗脱支架能长期改善急性心肌梗死患者的心率震荡,从而减少临床恶性心律失常事件的发生。Objectives To investigate the mid- and long-term effects of domestic produced sirolimus drug-eluting stent on heart rate turbulence in patients with acute myocardial infarction. Methods According to the different therapies, patients with acute myocardial infarction were divided into 2 groups： percutaneous coronary intervention （PCI） group （n=76） and routine medical treatment group （n=53）. The 24 h ambulatory eletrocardiolography was performed 24 h, 1 week, 3 months, 6 months, 12 months, and 24 months after PCI. Turbulence onset （TO） and turbulence slop （TS） were measured by the original definitions using digitized 24 h ambulatory eletrocardiolography. Results Compared to control group, TS [ （ 13.73 ±6.48 ） ms/RR vs. （ 1.21 ±0.53 ） ms/RR, P〈0.01 ] got significant improvement and TO （- 0.21%±1.95% vs. 0.26%±1.71%,P〈0.01） got significant decrease 24 h after the operation in PCI group, and this tendency was maintain for the following 24 monthons. Though TO and TS were improved after 3 monthons in control group （P〈0.05）, the improvements were significantly lower than those in PCI group （P〈0.05）. Conclusions Domestic drug-eluting stents implantation can improve heart rate turbulence in patients with acute myocardial infarction after a long time of the operation.

关 键 词：心肌梗死 血管成形术 经腔 经皮冠状动脉 支架 西罗莫司 心率震荡 

分 类 号：R542.22[医药卫生—心血管疾病]