论文部分内容阅读
目的探讨陈旧性心肌梗死患者窦性心率振荡现象和其他临床预测指标之间的关系。方法选择陈旧性心肌梗死患者50例,NYHA分级Ⅱ～Ⅳ级,行24动态心电图测量窦性心率振荡(HRT)参数,振荡起始(TO)和振荡斜率(TS),计算心率变异性(HRV)参数。24小时全部RR间期的标准差(SDNN)和三角指数。超声心动图检测左心室射血分数(LVEF),左心室收缩末期容积(LVESV)和左心室舒张末期容积(LVEDV)等进行比较分析。结果①HRT(TO,TS)显著增强现象心功能Ⅱ级组>心功能级Ⅲ组>心功能级IV组(p均<0.01)。LVEF≥30%组较<30%组显著(p<0.01)。②50例患者住院治疗后心功能改善。其HRT变化为显著增强(TO减小,TS增大。p均<0.01);LVEF、HRT的SDNN和三角指数显著增加;LVESV和LVEDV显著减少(p均<0.01);③HRT(TO,TS)变化的增强与减低和LVEF、LVESV、LVEDV和HRV(SDNN,三角指数)呈显著相关(p<0.01)。结论窦性心率振荡是陈旧性心肌梗死患者危险度分层及病死率预测的一项临床新指标。
Objective To investigate the relationship between sinus rhythm and other clinical predictors in elderly patients with myocardial infarction. Methods Fifty patients with AMI and NYHA class Ⅱ ~ Ⅳ were selected to measure heart rate variability (HRV), heart rate variability (HRV), heart rate variability (HRV) )parameter. Standard deviation of all 24-hour RR intervals (SDNN) and trigonometric indices. The left ventricular ejection fraction (LVEF), left ventricular end-systolic volume (LVESV) and left ventricular end-diastolic volume (LVEDV) were measured by echocardiography. Results ①HRT (TO, TS) significantly enhanced cardiac function Ⅱ level group> cardiac function level Ⅲ group> cardiac function level IV group (all p <0.01). LVEF≥30% group was significantly lower than <30% (p <0.01). ②50 patients after hospitalization improved cardiac function. The HRT changes were significantly increased (TO decreased, TS increased, all P <0.01); SDNN and trigone index of LVEF and HRT increased significantly; LVESV and LVEDV decreased significantly (all p <0.01) Changes in enhancement and decrease were significantly associated with LVEF, LVESV, LVEDV and HRV (SDNN, trigone index) (p <0.01). Conclusions Sinusoidal heart rate oscillation is a new clinical indicator of risk stratification and mortality in patients with old myocardial infarction.