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目的研究静脉溶栓与经皮冠状动脉介入(PCI)对急性心肌梗死(AMI)患者心率变异性(HRV)的影响。方法 78例AMI患者的临床资料做回顾性分析,对39例采取PCI治疗设为A组;另39例采用静脉溶栓治疗设为B组。对比治疗后两组HRV指标差异。结果 A组治疗后正常RR间期(SDNN)(88.1±18.2)ms、SDNN均值(SDNNI)(74.1±21.0)ms、SDNNI在24 h内正常时间超过5 min阶段(SD)(69.1±14.9)ms、以均方根表示的相邻RR间期差值(rMSSD)(29.9±4.3)ms、超过50 ms的相邻RR间期差值所占比例(Pnn_(50))(20.1±7.1)ms;B组经治疗后SDNN(27.2±8.2)ms、SDNNI(21.0±3.5)ms、SD(20.9±5.1)ms、rMSSD(19.3±4.1)ms、Pnn_(50)(16.9±3.5)ms;治疗后,A组SD、SDNNI以及SDNN指标均显著高于B组(P<0.01)。而A组Pnn_(50)与rMSSD指标高于B组(P<0.05)。结论对AMI患者采取PCI治疗,能显著改善HRV,值得临床应用。
Objective To investigate the effect of intravenous thrombolysis and percutaneous coronary intervention (PCI) on heart rate variability (HRV) in patients with acute myocardial infarction (AMI). Methods A retrospective analysis was performed on the clinical data of 78 patients with AMI. 39 patients were treated with PCI as Group A, and the other 39 patients treated with intravenous thrombolysis as Group B. The differences of HRV indexes between two groups after treatment were compared. Results After treatment, the normal RR interval (SDNN), SDNNI (74.1 ± 21.0) ms and SDNNI (69.1 ± 14.9) within 24 hours after treatment were significantly higher in group A ms, rmsSD (29.9 ± 4.3) ms in root mean square, and Pnn_ (50) (20.1 ± 7.1), which is the difference between adjacent RR intervals over 50 ms (P <0.05). The mean time to treatment of SDNN was (21.2 ± 8.2) ms, SDNNI was 21.9 ± 3.5 ms, SD was 20.9 ± 5.1 ms, rMSSD was 19.3 ± 4.1 ms, Pnn_50 was 16.9 ± 3.5 ms, After treatment, the indexes of SD, SDNNI and SDNN in group A were significantly higher than those in group B (P <0.01). The Pnn_ (50) and rMSSD index in group A were higher than those in group B (P <0.05). Conclusions PCI in patients with AMI can significantly improve HRV, which is worthy of clinical application.