急性心肌梗死后心率变异性和心源性猝死危险性的关系  

The Relationship Between Heart Rate Variability and Sudden Cardiac Death After Acute Myocardial Infarction

作　　者：易远明[1] 

机构地区：[1]广东省吴川市人民医院心血管内科,广东吴川524500

出　　处：《河北医学》2014年第1期59-62,共4页Hebei Medicine

摘　　要：目的:探讨急性心肌梗死(AMI)患者心率变异性(HRV)变化与猝死的关系。方法:选择我院2002年5月至2012年12月收治入院的AMI后心源性猝死(SCD)死亡患者100例和健康体检者100例,对其超声左室射血分数(LVEF),心电图QRS宽度、QT间期、校正QT间期(QTc)进行回顾性分析;另对2011年5月至2013年1月收治入院的被列入猝死高危范围心脏病患者50例和低危患者50例,并对SDNN、SDANN、rMSSD、PNN50、LF、HF、TF、LF/HF等指标进行统计学分析。结果:SCD组QRS、QT、QTc值高于对照组,而SCD组LVEF值低于对照组,且两组比较差异有统计学意义(P<0.05);高危组的SDNN、SDANN、rMSSD、PNN50、LF、HF、TF、LF/HF均低于低危组,所有指标均有统计学意义(P<0.05或0.01、0.0001)。结论:AMI急性期HRV明显下降,提示早期检测AMI后的HRV指标可预测心源性猝死的发生。Objective：To investigate the relationship between heart rate variability （ HRV） changes and sudden cardiac death of acute myocardial infarction （ AMI） .Methods：From May 2002 to December 2012 , 100 cases of AMI died of sudden cardiac after admitted to our hospital , and 100 cases of healthy subjects were selected.left ventricular ejection fraction （LVEF）, electrocardiogram QRS duration, QT interval, cor-rected QT interval （ QTc ） were retrospectively analyzed; And then 50 patients with high-risk of sudden death, and 50 cases of low-risk patients from May 2011 to January 2013 were selected, and SDNN, SDANN, rMSSD, PNN50, LF, HF, TF, LF /HF and other indicators were statistically analyzed.Results：QRS, QT, QTc values of SCD group was higher than those in control group, LVEF was lower than that in the control group, and the difference was statistically significant （ P 〈0.05 ）; SDNN, SDANN, rMSSD, PNN50, LF, HF, TF, LF /HF of high-risk group were lower than those in low-risk group , all indicators were statistically significant （ P〈0 .05 or 0 .01 ,0 .0001 ） .Conclusion：The HRV in acute phase of AMI de-crease significantly , which suggesting that early detection of HRV after AMI indicators can predict the occur-rence of sudden cardiac death.

关 键 词：心率变异 急性心肌梗死 心源性猝死 预测因素 

分 类 号：R542.22[医药卫生—心血管疾病]