PTCA及支架安装术后患者近期的心率变异性  

Heart rate variability in early stage after percutancous transluminal coronary angioplasty and stent

作　　者：郭文怡[1] 贾国良[1] 陈兰芳[1] 区晋禧[1] 贾国军[1] 张玉顺[1] 郑昌柱[1] 刘兵[1] 李媛[1] 王小燕[1] 

机构地区：[1]第四军医大学西京医院心血管内科,陕西西安710033

出　　处：《第四军医大学学报》2000年第12期1522-1523,共2页Journal of the Fourth Military Medical University

摘　　要：目的　观察不同病变的冠心病患者行 PTCA及支架安装术后近期心率变异性 (HRV)的变化 ,揭示 PTCA及支架安装术对患者自主神经功能的影响 .方法　选择我科 1995 -0 6 / 1997- 12经 PTCA和 (或 )支架安置术的患者 97例 (治疗组 ) ,于手术后 3～ 7d行 Holter检查 ,其中 5 4例与术前的Holter做对照 ,并与 32例冠脉造影正常的不典型胸痛患者(正常对照组 )、2 9例经冠脉造影证实为单支或多支冠脉病变 ,但未行介入治疗的冠心病患者 (未行介入治疗组 )进行了对照研究 .应用 2 4h动态心电图监测 .选择 7项 HRV时域指标 ,4项频域指标进行对比分析 .结果　手术前后自身对照 5 4例HRV各项指标无显著差异 ,97例治疗组与正常组对照 ,MSD,r MSSD,PNN5 0及 HF,L F/ HF等指标差异显著 (P<0 .0 5 ) .与 2 9例未行介入治疗组相比仅个别患者指标接近正常 ,总体相比无显著差异 .结论　在冠心病介入性治疗近期 ,患者的HRV指标暂无明显变化 .是否心绞痛患者或急性心肌梗死后患者的心率变异指标本身尚存在差异 。AIM To observe the changes of heart rate variability in the early stage after percutaneous transluminal coronary angioplasty and stenting. To evaluate the effects of coronary angioplasty and stenting on autonomic nerve activity in patients with coronary heart disease. METHODS Ninety-seven patients underwent successful PTCA or/and stenting to measure heart rate variability with 24-hour holter 3~7 d after the procedure (Group A). The parameters of 54 cases of them were compared with the ones of themselves before procedure.32 patients with chest pain, who were angiographically proven that coronary arteries were normal, were the control group B1. Other 29 patients with three-vessel coronary artery disease who had no interventional therapy were the control group B2. HR and its variability in the time (7 kinds) and frequency (4 kinds) domains were analyzed in all patients of each group. RESULTS There was no difference between after and before procedure (PTCA) in 54 cases of group A. Time domain (such as MSD, RMSSD, PNN50) and frequency domain (such as HF, LF, LF/HF) were still lower in group A than in group B1 (P< 0.05); whereas no significant changes existed between group A and group B2 though there were slightly higher in severe time domain and frequency domain. CONCLUSION In the early stage after percutanous transluminal coronary angioplasty and/or stenting, there are no significant changes of heart rate variability.

关 键 词：冠脉腔内成形术 心率变异性 冠心病 支架植入术 

分 类 号：R541.4[医药卫生—心血管疾病] R654.2[医药卫生—内科学]