PCI治疗对AMI患者心率震荡的影响及临床意义(1)
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【摘要】 目的 探讨PCI治疗对AMI患者HRT的影响及临床意义。方法 选择60例AMI患者，按PCI治疗及药物治疗分为2组，PCI治疗组40例(直接PCI治疗组与延迟PCI治疗组各20例)，药物治疗组20例；分别计算各组震荡初始(TO)、震荡斜率(TS)进行对比分析。再观察单分支病变23例及多分支病变17例HRT指标的区别。结果 PCI治疗组与药物治疗组心率震荡差异有统计学意义。直接PCI治疗组与延迟PCI治疗组心率震荡差异有统计学意义。AMI多支病变组TO高于单支病变组，而TS明显低于单分支病变组。结论 PCI治疗对AMI患者HRT各参数改善均优于药物治疗。直接PCI治疗比延迟PCI治疗HRT明显改善，说明越早开通梗死相关动脉心功能改善越明显。AMI多支病变组较单支病变组HRT现象明显减弱，预示急性心肌梗死时多分支病变比单支病变猝死的危险性增加。
【关键词】
AMI；HRT；DCG；PCI治疗
Influence of heart rate turbulence in AMI patients after PCI treatment
LIN Yuqun, LIN Wenbing, HUANG Wenzheng, et al.
Cardiology Department of First Affiliated Hospital, Shantou University Medical College,Shantou 515041,China
【Abstract】 Objective To investigate influence of HRT in AMI patients after PCI treatment.Methods Turbulance onset(TO) and turbulance slope(TS) of HRT were measured in 60 cases of AMI patients who were divided into two groups,PCI group(40 cases)and medication group(20 cases).We also compared the difference between directly PCI group and elective PCI group,as well as mutivessel coronary disease group and singlevessel coronary disease group.Results The difference of HRT between PCI group and medication group was statistically significant,as well as the difference between directly PCI group and elective PCI group.Furthermore,TO in mutivessel coronary disease group was higher than singlevessel coronary disease group.On the contrary,TS was significant low in mutivessel coronary disease group.Conclusion HRT indices are improved in AMI patients after PCI treatment.Data indicated the earlier myocardial infarction related artery reperfused the better cardiac function improved. HRT significantly weakened in mutivessel coronary disease group than that in singlevessel coronary disease group which predicted a high sudden death risk in AMI patients with mutivessel coronary disease.
【Key words】
AMI; HRT; DCG; PCI
基金项目:2009年广东省卫生厅科研项目(项目编号:B2009171)
作者单位：515041汕头大学医学院第一附属医院心内科(林毓群 林汶彬 黄文正);潮南民生医院心电图室(赵巧专)
急性心肌梗死(AMI)是在冠脉病变的基础上发生冠脉血供急剧减少或中断，使相应心肌严重而持久缺血所致的坏死，是心脏性猝死的高危人群，对其死亡率及发生心血管事件的危险性进行预测，是目前临床研究的热点。而心率震荡1](HRT)作为有效预测心肌梗死后患者的危险性的新指标 ......
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