影像科学与光化学 ›› 2022, Vol. 40 ›› Issue (4): 804-809.DOI: 10.7517/issn.1674-0475.220310

• 综述与论文 • 上一篇    下一篇

HRV参数与AMI患者梗死部位、病变血管支数及预后的关系

陈志洁1, 汪春庆1, 康小琴1, 许欣2, 张志宇1   

  1. 1. 青海大学附属医院心血管内科心电图室, 青海 西宁 810000;
    2. 青海大学附属医院心血管内科, 青海 西宁 810000
  • 收稿日期:2022-03-08 发布日期:2022-07-09
  • 通讯作者: 陈志洁, 汪春庆

Relationship between HRV Parameters and Infarct Site, Number of Diseased Blood Vessels and Prognosis in Patients with AMI

CHEN Zhijie1, WANG Chunqing1, KANG Xiaoqin1, XU Xin2, ZHANG Zhiyu1   

  1. 1. ECG Room, Department of Cardiovascular Medicine, Qinghai University Affiliated Hospital, Xining 810000, Qinghai, P. R. China;
    2. Department of Cardiovascular Medicine, Affiliated Hospital of Qinghai University, Xining 810000, Qinghai, P. R. China
  • Received:2022-03-08 Published:2022-07-09

摘要: 本研究探讨心率变异性(HRV)参数在不同梗死部位、不同冠脉病变支数及不同预后结局的急性心肌梗死(AMI)患者中的差异及其意义。选取已确诊的200例AMI患者作为AMI组、另外选取200例非冠心病患者作为对照组,检测AMI组和对照组的HRV参数。按照不同冠脉病变支数、不同梗死部位、随访18个月后患者是否发生主要不良心血管事件(MACE)进行分层分析,比较HRV参数变化。结果显示,AMI组的SDNN、SDANN、SDNNI、RMSSD、PNN50均低于对照组(P<0.05);AMI组中,有非ST段抬高的AMI患者28例、前壁性心肌梗死114例、下壁性心肌梗死58例,前壁AMI患者的SDNN、SDANN、SDNNI低于非ST段抬高、下壁AMI患者(P<0.05);发生MACE患者的SDNN、SDANN低于未发生MACE的AMI患者(P<0.05)。通过观察AMI患者早期的HRV参数,对于诊断心肌梗死部位及患者预后具有一定的临床参考价值。

关键词: 心率变异性参数, 梗死部位, 冠脉病变支数, 预后结局, 急性心肌梗死

Abstract: This study investigated the differences and significance of heart rate variability (HRV) parameters with different infarct sites, different coronary artery disease branch numbers and different prognosis outcomes in patients with acute myocardial infarction (AMI). 200 confirmed AMI patients were selected as the AMI group, and 200 non-coronary heart disease patients were selected as the control group. The HRV parameters of the AMI group and the control group were detected. Patients were stratified according to the number of coronary artery lesions, different infarct sites and major adverse cardiac events (MACE) after 18 months of follow-up, and the changes of HRV parameters were analyzed. The results showed the SDNN, SDANN, SDNNI, RMSSD, and PNN50 in the AMI group were all lower than those in the control group (P<0.05). In the AMI group, there were 28 patients with non-ST segment elevation, 114 patients with myocardial infarction of anterior wall and 58 patients with myocardial infarction of inferior wall. The SDNN, SDANN and SDNNI of patients with anterior wall AMI were lower than those of patients with non-ST segment elevation and inferior wall AMI (P<0.05). The SDNN and SDANN of patients with MACE events were lower than those of AMI patients without MACE (P<0.05). Observing the early HRV parameters of AMI patients has a certain clinical reference value for the diagnosis of myocardial infarction site and patient prognosis.

Key words: heart rate variability parameters, infarct location, number of coronary artery lesions, prognostic outcome, acute myocardial infarction