动态心电图参数诊断急性心肌梗死患者室性心律失常的应用价值  

Application value of ambulatory electrocardiographic parameters in diagnosing ventricular arrhythmia of patients with acute myocardial infarction

作　　者：温桂凤 WEN Guifeng(Department of Electrocardiography,the Second Hospital of Longyan,Longyan Fujian 364000,China)

机构地区：[1]龙岩市第二医院心电图科,福建龙岩364000

出　　处：《实用心电学杂志》2024年第6期621-624,共4页Journal of Practical Electrocardiology

摘　　要：目的 探究24 h动态心电图参数在临床诊断急性心肌梗死(acute myocardial infarction,AMI)患者室性心律失常中的应用价值。方法 选择200例AMI患者进行动态心电图检查,并记录相关参数。按照有无发生室性心律失常,将患者分为室性心律失常组和无室性心律失常组。比较两组24 h动态心电图参数:rMSSD、SDNN、SDANN-index、QT间期变异度(QT interval variability,QTV)。利用Logistic回归分析,探讨24 h动态心电图参数与AMI患者发生室性心律失常的关系,并采用ROC曲线分析,研究这些参数对诊断AMI患者室性心律失常的效能。结果 200例AMI患者中有76例发生室性心律失常,发生率为38.0%。室性心律失常组AMI患者的rMSSD、SDNN、SDANN-index、QTV均明显低于无室性心律失常组(均P<0.05)。Logistic回归分析结果显示,rMSSD、SDNN、SDANN-index、QTV均与AMI患者发生室性心律失常有关(均P<0.05)。ROC曲线分析显示,rMSSD、SDNN、SDANN-index、QTV诊断AMI患者发生室性心律失常的AUC值分别为0.907、0.761、0.819、0.906,具有一定的预测价值。结论 24 h动态心电图参数rMSSD、SDNN、SDANN-index和QTV在AMI患者发生室性心律失常的临床诊断中具有一定的应用价值。Objective To explore the application value of 24-hour ambulatory electrocardiographic parameters in the clinical diagnosis of ventricular arrhythmia in patients with acute myocardial infarction(AMI).Methods A total of 200 AMI patients were performed by ambulatory electrocardiography(AECG) examination,and related parameters were recorded.According to the presence or absence of ventricular arrhythmia,the enrolled patients were divided into ventricular arrhythmia group and non-ventricular arrhythmia group.The 24-hour AECG parameters of rMSSD,SDNN,SDANN-index and QT interval variability(QTV) were compared between the two groups.Logistic regression analysis was used to explore the relationship between 24-hour AECG parameters and ventricular arrhythmia occurred in AMI patients;ROC curve analysis was utilized to investigate the efficiency of these parameters in the diagnosis of ventricular arrhythmia among AMI patients.Results Among the 200 AMI patients,76 cases developed ventricular arrhythmia,with an incidence rate of 38.0%.The indexes of rMSSD,SDNN,SDANN-index and QTV of the AMI patients in the ventricular arrhythmia group were all significantly lower than those in the non-ventricular arrhythmia group(all P<0.05).Logistic regression analysis results showed that rMSSD,SDNN,SDANN-index and QTV were all related to the occurrence of ventricular arrhythmia among AMI patients(all P<0.05).ROC curve analysis revealed that the AUC values of rMSSD,SDNN,SDANN-index and QTV in the diagnosis of ventricular arrhythmia among AMI patients were 0.907,0.761,0.819 and 0.906,respectively,with a certain predictive value.Conclusion The 24-hour AECG parameters of rMSSD,SDNN,SDANN-index and QTV have application values in the clinical diagnosis of ventricular arrhythmia among AMI patients.

关 键 词：急性心肌梗死 动态心电图 室性心律失常 QT变异度 

分 类 号：R540.41[医药卫生—心血管疾病]