检测自主神经张力指标对急性心肌梗死患者心脏不良事件的预测价值  

Predictive value of autonomic nerve tension detection in adverse cardiac events of patients with acute myocardial infarction

作　　者：王帆 覃艳笑 黄东菊 WANG Fan;QIN Yan-xiao;HUANG Dong-ju(Department of ECG Diagnosis,Wuming Hospital of Guangxi Medical University,Nanning 530199,China)

机构地区：[1]广西医科大学附属武鸣医院心电诊断科

出　　处：《中国医学装备》2019年第6期80-83,共4页China Medical Equipment

基　　金：广西南宁市武鸣区科学研究与技术开发计划(20160314)“不同时期心率减速力变化对心肌梗死后患者猝死风险的预警价值研究”

摘　　要：目的:探讨心率减速力(DC)、连续8个周期的DC(DR8)及心率变异性(HRV)对急性心肌梗死患者心脏不良事件(MACE)的预测价值。方法:回顾性选取医院收治的36例急性心肌梗死患者资料,将其纳入观察组,另选取36名健康志愿者纳入健康对照组,对两组行24h动态心电图检查,比较两组疾病危险分层结果,并分析观察组患者的心率变异性总标准差(SDNN)与连续2个周期的DC(DR2)、连续4个周期的DC(DR4)、DR8及DC间的相关性。结果:观察组患者的DC、DR2、DR4、DR8以及SDNN水平均显著低于健康对照组,差异有统计学意义(t=12.543,t=11.525,t=12.942,t=11.157,t=13.327;P<0.05);观察组低度危险患者所占比例显著低于健康对照组,差异有统计学意义(x^2=5.675,P<0.05);观察组中度危险、高度危险患者所占比例均高于健康对照组,差异有统计学意义(x^2=4.254,x2=5.142;P<0.05);观察组SDNN水平与DR2、DR4、DR8以及DC均呈正相关(r=0.222,r=0.254,r=0.315,r=0.368;P<0.05)。结论:DC和DRs均可成为一种较好的预测急性心肌梗死患者心脏不良事件指标,且HRV与DC以及DRs均有相关性,具有较高的临床预测价值。Objective: To investigate the predictive value of heart rate deceleration (DC), heart rate deceleration runs (DRs) with continue 8 periods and heart rate variability (HRV) for major adverse cardiac events (MACE) in patients with acute myocardial infarction (AMI). Methods: The clinical data of 36 patients with AMI were retrospectively analyzed and they were included in the observation group, and thirty-six healthy volunteers were selected as healthy control group. And 24-hour dynamic electrocardiogram (DCG) was performed in the two groups, and the results of disease risk stratification between the two groups were compared. The correlations between the SDNN and DC with consecutive 2 periods (DR2), DC with consecutive 4 periods (DR4), DR8 and DC of patients of observation group were analyzed. Results: The levels of DC, DR2, DR4, DR8 and SDNN in the observation group were significantly lower than those in the healthy control group (t=12.543, t=11.525, t=12.942, t=11.157, t=13.327, P<0.05), respectively. The proportion of patients with low-risk in the observation group was significantly lower than that in the healthy control group (x^2=5.675, P<0.05). The proportions of patients with middle-risk and high-risk in observation group were significantly higher than that in the healthy control group (x^2=4.254, x2=5.142, P<0.05), respectively. SDNN levels in the observation group were positively correlated with DR2, DR4, DR8 and DC (r=0.222, r=0.254, r=0.315, r=0.368, P<0.05). Conclusion: Both DC and DRs can be used as a good predictor of adverse cardiac events in patients with AMI. And HRV is correlative with DC and DRs. They have higher clinical predictive value.

关 键 词：心率减速力 心率变异性 急性心肌梗死 心脏不良事件 预测价值 

分 类 号：R542.22[医药卫生—心血管疾病]