心率变异性对急性心肌梗死患者心脏自主功能的评价作用  

Evaluation value of heart rate variability on cardiac autonomic function in patients with acute myocardial infarction

作　　者：董宁[1] 崔海玲[1] Dong Ning;Cui Hailing(Department of Physical Function,Yan’an People’s Hospital of Shaanxi Province,Yan’an 716000,China)

机构地区：[1]陕西省延安市人民医院功能科,延安716000

出　　处：《广西医科大学学报》2020年第3期474-478,共5页Journal of Guangxi Medical University

摘　　要：目的:探讨心率变异性(HRV)对急性心肌梗死患者心脏自主功能的评价作用。方法:选取2017年1月至2019年1月陕西省延安市人民医院收治的急性心肌梗死患者200例,其中心脏自主功能异常148例作为异常组,正常52例作为正常组。采用动态心电图检测HRV[正常R-R间期标准差(SDNN)、R-R间期差值高于50 ms部分占比(PNN50)、5 min正常R-R间期平均值标准差(SDANN)、连续5 min R-R间期差值均方根(rMSSD)、低频成分(LF)、高频成分(HF)],分析HRV对急性心肌梗死患者心脏自主功能的评价作用。结果:异常组SDNN、PNN50、SDANN、rMSSD明显低于正常组(P<0.05)。正常组和异常组的LF、HF比较,无明显差异(P>0.05)。受试者工作特征曲线(ROC曲线)分析显示,采用SDNN<102 ms或PNN50<10%或SDANN<102.6 ms或rMSSD<39 ms四者联合评价急性心肌梗死患者心脏自主功能异常的特异度、敏感度、准确度分别为96.15%、98.65%、98.00%,四者联合时的特异度、敏感度、准确度均明显高于四者单独时(P<0.05)。结论:HRV中SDNN、PNN50、SDANN、rMSSD等指标与急性心肌梗死患者心脏自主功能有关,可作为评价心脏自主功能的重要指标,且四者联合时的评价作用更高。Objective:To investigate the role of heart rate variability(HRV)in evaluation of cardiac autonomic function in patients with acute myocardial infarction(AMI).Methods:A total of 200 patients with AMI admitted in Yan’an People’s Hospital of Shaanxi Province from Jan.2017 to Jan.2019 were selected.Among them,148 patients with abnormal cardiac autonomic function were included in the abnormal group and 52 patients with normal cardiac autonomic function as the normal group.Dynamic electrocardiogram was used to detect HRV(standard deviation of NN intervals(SDNN),50 ms different from the previous interval(PNN50),5 min normal SD of the average of normal R-R intervals(SDANN),continuous 5 min root mean square of successive R-R intervals differences(rMSSD),low frequency component(LF),high frequency component(HF)),and the value of HRV in evaluating cardiac autonomic function in patients with AMI was analyzed.Results:SDNN,PNN50,SDANN,and rMSSD in the abnormal group were significantly lower than those in the normal group(P<0.05).There were no significant difference in LF and HF between normal and abnormal groups(P>0.05).ROC curve showed that the specificity,sensitivity,and accuracy of abnormal cardiac autonomic function in patients with AMI were 96.15%,98.65%,and 98.00%,respectively when combination of SDNN<102 ms and PNN50<10%and SDANN<102.6 ms and rMSSD<39 ms,which were significantly higher than those of their alone(P<0.05).Conclusion:The indexes of SDNN,PNN50,SDANN,and rMSSD in HRV are related to the cardiac autonomic function of patients with AMI,which can be used as important indexes to evaluate the cardiac autonomic function,and the combination of the four indexes has a higher evaluation effect.

关 键 词：心率变异性 急性心肌梗死 心脏自主功能 

分 类 号：R542.22[医药卫生—心血管疾病]