心电图心率变异性参数对急性心肌梗死患者预后的预测价值  

Prognostic value of ECG heart rate variability parameters in patients with AMI

作　　者：陈思维 谷建峰 罗勤[1] 赖小娣 闫博宇 CHEN Siwei;GU Jianfeng;LUO Qin;LAI Xiaodi;YAN Boyu(Pingxiang People's Hospital of Jiangxi Province,Pingxiang 337000,China)

机构地区：[1]萍乡市人民医院,江西萍乡337000

出　　处：《临床医药实践》2024年第4期267-270,共4页Proceeding of Clinical Medicine

基　　金：江西省卫生健康委员会科技计划项目(项目编号:202212193)。

摘　　要：目的:探讨心电图心率变异性(HRV)参数对急性心肌梗死(AMI)患者预后的预测价值。方法:回顾性收集2021年10月—2022年12月收治的79例AMI患者的临床资料,根据患者预后情况分为存活组(65例)和病死组(14例),全部患者均接受心电图HRV检测,且病例资料、检查资料完整;对比两组心电图HRV相关参数[RR间期平均值标准差(SDANN)、相邻RR间期差值均方根(RMSSD)、窦性心搏RR间期标准差(SDNN)、0~0.40 Hz总频谱成分(TF)、0.14~0.30 Hz低频成分(LF)/0.15~0.40 Hz高频成分(HF)比值],分析心电图HRV参数预测AMI患者预后不良的风险价值。结果:病死组SDANN,RMSSD,SDNN,TF较存活组低,LF/HF较存活组高,差异有统计学意义(P<0.05)。绘制受试者工作特征曲线(ROC)发现,心电图HRV的SDANN,RMSSD,SDNN,TF,LF/HF参数单独及联合检测预测AMI患者预后不良的曲线下面积(AUC)均>0.70,均有一定价值,其中联合检测预测价值最高。结论:心电图HRV参数对AMI患者预后有较高的预测价值,可作为患者预后的重要评估指标。Objective:To investigate the prognostic value of ECG heart rate variability(HRV)parameters in patients with acute myocardial infarction(AMI).Methods:All 79 patients with AMI admitted to hospital from October 2021 to December 2022 were retrospectively collected and divided into survival group(65 cases)and death group(14 cases)according to their prognosis.All patients received electrocardiogram(ECG)HRV detection,and the case data and examination data were complete.The HRV-related parameters[mean standard deviation between RR intervals(SDANN),root mean square difference between adjacent RR intervals(RMSSD),standard deviation between sinus beats RR intervals(SDNN),total spectrum component of 0~0.40 Hz(TF),low frequency component of 0.14~0.30 Hz(LF)/0.15~0.40 Hz high frequency(HF)were compared between the two groups,the risk value of ECG HRV parameters in predicting poor prognosis in AMI patients was analyzed.Results:The SDANN,RMSSD,SDNN,TF in death group were lower than those in survival group,the LF/HF in death group was higher than it in survival group,and the difference was statistically significant(P<0.05).Receiver operating characteristic curve(ROC)showed that the area under the curve area under the curve(AUC)of ECG parameters HRV SDANN,RMSSD,SDNN,TF and LF/HF were all>0.70 in predicting poor prognosis of AMI patients by single detection and combined detection,and the combined detection had the highest predictive value.Conclusion:ECG HRV parameters have high prognostic value for AMI patients and can be used as an important prognostic indicator in the future.

关 键 词：急性心肌梗死 心电图 心率变异性 预后 预测价值 

分 类 号：R540.41[医药卫生—心血管疾病]