心率变异性和QT间期变异性与急性心肌梗死患者室性心律失常的关系研究  

Study on the relationship between heart rate variability and QT interval variability with ventricular arrhythmia in acute myocardial infarction patients

作　　者：桑城[1] 郝恒剑[1] 许骥[1] 史力生[1] 

机构地区：[1]首都医科大学宣武医院心脏科,北京100053

出　　处：《中国循证心血管医学杂志》2018年第2期230-232,共3页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的探讨心率变异性(HRV)和QT间期变异性(QTV)与急性心肌梗死(AMI)患者室性心律失常(VA)的关系。方法入选75例在首都医科大学宣武医院心脏科住院的AMI患者,按室性期间收缩Lown's分级对VA进行评估,分为Lown's 1~2级组21例与Lown's 3~5级组54例,同时选择同期健康者50例为正常对照组。对所有受试者进行24 h动态心电图检查,监测室性心律失常、24 h正常R-R间期的标准差(SDNN)、24 h连续5 min正常R-R间期标准差的均值(SDNNindex)、24 h连续5 min正常R-R间期的标准差(SDANNindex)、相邻正常R-R间期差值的均方根(rMSSD)及24 h QT间期。结果与正常对照组比较,AMI组SDNN、SDNNindex、SDANNindex、rMSSD及24 h QTV均明显减小(P均<0.05);与Lown's 1~2级组比较,Lown's 3~5级组除r MSSD外,其它SDNN、SDNNindex、SDANNindex及24 h QTV均明显减小(P<0.05)。结论 HRV与QTV与心肌梗死后室性心律失常严重程度明显相关。Objective To investigate the relationship between heart rate variability and QT interval variability with ventricular arrhythmia in acute myocardial infarction （AMI） patients. Methods By Lown＇s standard, 75 AMI patients were enrolled and divided into Lown＇s 1~2 group with 21 cases and Lown＇s 3~5 group with 54 cases. And 50 healthy subjects were enrolled as normal control group. All subjects underwent 24-hour Holter monitoring. Ventricular arrhythmia, standard deviation of 24 h normal R-R interval （SDNN）, mean of the standard deviation of the normal R-R interval of 5 min continuous 24 h （SDNNindex）, standard deviation of the normal R-R interval of 5min continuous 24 h （SDANNindex）, root mean square value of adjacent normal R-R interval （rMSSD） and 24 h QT interval were monitored. Results Compared with the normal control group, SDNN, SDNNindex, SDANNindex, rMSSD and 24 h QTV were significantly decreased in AMI patients （P〈0.05）. Compared with the Lown＇s 1~2 group, SDNN, SDNNindex, SDANNindex and 24 h QTV were significantly reduced in Lown＇s 3~5 group （P〈0.05）, except rMSSD. Conclusion HRV and QTV can be used as predictors of severity of ventricular arrhythmias after myocardial infarction.

关 键 词：心率变异性 QT间期变异性 急性心肌梗死 室性心律失常 

分 类 号：R542.22[医药卫生—心血管疾病]