急性心肌梗死患者早期心律震荡与梗死面积及预后的关系研究  

STUDY ON THE HEART RATE TURBULENCE AND AREA OF INFARCTION AND PROGNOSIS IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION IN THE EARLY STAGE

作　　者：黄学成[1] 陈青萍[1] 袁智萍[1] 尚晓斌[1] 王琦武[1] 梁艺[1] 邓梓谦[1] 

机构地区：[1]广西医科大学第三附属医院心血管内科,南宁530031

出　　处：《现代预防医学》2011年第21期4515-4516,4518,共3页Modern Preventive Medicine

基　　金：南宁市科学技术局资助项目(200802110C)

摘　　要：[目的]探讨急性心肌梗死(AMI)患者早期心律震荡(HRT)与梗死面积及预后的关系。[方法]选择165例早期AMI患者进行24h动态心电图(Holter)检查,计算HRT的两个参数:震荡初始(TO)和震荡斜率(TS),并对TO、TS进行分析。所有患者根据是否发生心源性死亡分为死亡组和生存组。规定12导心电图中病理性Q波导联数≥4者为大面积梗死,≤3者为小面积梗死。组间比较采用χ2检验。[结果]死亡组TO≥0且TS≤2.5ms/RR间期的阳性率显著高于生存组(P﹤0.01)。大面积AMI组TO≥0且TS≤2.5ms/RR间期的阳性率显著高于小面积AMI组(P﹤0.01)。[结论]TO,TS值的变化与AMI患者早期的心源性死亡及梗死面积密切相关。HRT的减弱或消失可作为预测AMI患者早期发生恶性心脏事件的敏感指标之一。[Objective]To investigate the heart rate turbulence（HRT）and area of infarction and prognosis in patients with acute myocardial infarction（AMI）in the early stage.[Methods]165 cases of patients with AMI in the early stage were examined by 24h Holter monitoring.Two factors that turbulence onset（TO）and turbulence slope（TS）of HRT were measured and analyzed.All patients were considered into the death group and the living group according to cardiac death.And stipulated：in the routine 12-leads electrocardiogram（ECG）,the pathological Q waves ≥4 were massive infarction and ≤3 were less infarction.The data were analyzed by chi-square test for the group comparison.[Results]The positive rate in the patients of the death group was significantly higher than the living group at TO≥0,TS≤2.5ms/RR interval（P﹤0.01）.The positive rate in the massive infarction group was significantly higher than the lesser infarction group at TO≥0,TS≤2.5ms/RR interval（P﹤0.01）.[Conclusion]The present study shows the level of TO and TS are closely correlated with cardiac death and area of infarction in patients with AMI in the early stage.The weak and vanishing of HRT might be used as one of sensitive targets in predicting severe cardiac events in patients with AMI in the early stage.

关 键 词：心律震荡 急性心肌梗死早期 梗死面积 预后 

分 类 号：R542.22[医药卫生—心血管疾病]