不同治疗方法对急性心肌梗死合并心功能不全患者心率变异性的影响  

Effect of different treatments on heart rate variability in cardiac insufficiency patients with acute myocardial infarction

作　　者：黄美琴[1] 肖慧敏[1] 李小珠[1] 

机构地区：[1]广东省湛江中心人民医院心电室,广东湛江524037

出　　处：《中国当代医药》2014年第3期21-23,共3页China Modern Medicine

基　　金：广东省湛江市科技计划项目(2013B01106)

摘　　要：目的探讨不同治疗方法对急性心机梗死（AMI）合并心功能不全（CI）患者心率变异性（HRV）的影响。方法选择本院2010年1月～2013年1月收治的100例AMI合并CI患者作为观察对象，随机分为观察组和对照组，每组各50例。观察组采用PCI手术介入治疗、对照组采用常规药物保守治疗。两组患者均于术后以及药物治疗后1周、1个月及3个月时记录24h动态心电图。对比两组不同时段HRV的变化特点与趋势，以及两组治疗后不同心功能分级再缺血事件发生率以及死亡率。结果治疗3个月，观察组SDNN、SDANN、RMSSD、PNN50水平均显著高于对照组，差异有统计学意义（P〈0．05）；观察组KillipⅡ～Ⅲ再缺血事件发生率及死亡率均显著高于对照组，差异有统计学意义（P〈0．05）。结论PCI治疗AMI合并CI患者的效果显著，对AMI合并CI患者进行HRV检测。可以较好地对早期心血管事件进行高危识别，值得推荐。Objective To explore the effect of the different therapeutic methods for acute myocardial infarction （AMI） complicated with cardiac insufficiency （CI） patients with heart rate variability （HRV）. Methods 100 patients with AMI combined with CI in our hospital from January 2010 to January 2013 were selected as observation objects,and they were randomly divided into observation group and control group,50 cases in each group.The observation group was treated with PCI,the control group was treated with conventional conservative drugs.24 hour dynamic ECG in two groups of patients after operation and 1 weeks after drug treatment,1 months and 3 months were recorded,the different HRV characteristics,trends,and different classification of cardiac function＇s rate of ischemic events and mortality of two groups were compared. Results After 3 months treatment,SDNN,SDANN,RMSSD,PNNs0 levels in observation group were significantly higher than those in control group,the differences were statistically significant （P〈0.05）.Killip Ⅱ-Ⅲ and the incidence of ischemic events and mortality in observation group were significantly higher than those in control group,the difference had statistical significance （P〈0.05）. Conclusion PCI has a good effect on treatment AMI pa- tients combined with CI,detection of HRV in AMI patients with Cl,can be used to conduct risk identification of early cardiovascular events.h is worthy of recommendation.

关 键 词：心肌梗死 心功能不全 心率变异性 

分 类 号：R542.22[医药卫生—心血管疾病]