心电图心率变异性参数与AMI患者心肌损伤的关系及联合预测预后分析

doi:10.7517/issn.1674-0475.210215

摘要/Abstract

摘要： 选取我院145例急性心肌梗死（AMI）患者作为研究对象，探究心电图心率变异性（HRV）参数与AMI患者心肌损伤的关系及联合预测预后的应用价值。结果发现，年龄≥60岁、发病至就诊时间>6 h、吸烟史、高脂血症史、心肌损伤标志物（CK-MK、cTnI、NT-proBNP）水平升高、LF/HF升高，以及SDNN、SDANN、RMSSD、PNN50下降为AMI患者死亡危险因素，急诊介入治疗为保护因素（P<0.05）；CK-MK、cTnI、NT-proBNP与SDNN、SDANN、RMSSD、PNN50呈负相关，与LF/HF呈正相关（P<0.05）；CK-MK、cTnI、NT-proBNP、SDNN、SDANN、RMSSD、PNN50、LF/HF联合预测AMI患者预后的AUC为0.914，高于单独预测。心电图HRV参数与AMI患者心肌损伤相关，且各指标联合可作为预后预测的重要手段，为临床提供依据。

关键词: 心电图, 心率变异性, 急性心肌梗死, 心肌损伤, 预后

Abstract: One hundred and forty-five cases of acute myocardial infarction (AMI) patients in our hospital were selected as the research objects to explore the relationship between electrocardiogram (ECG) heart rate variability (HRV) parameters and myocardial injury in patients with AMI and the application value of combined prediction of prognosis. The results showed that the age ≥ 60 years old, the time from onset to treatment > 6 hours, smoking history, hyperlipidemia history, the increase of myocardial injury markers (CK-MK, cTnI, and NT-proBNP) and LF/HF, and the decrease of SDNN, SDANN, RMSSD and pNN50 were the risk factors of death in patients with AMI, while emergency intervention was the protective factor (P<0.05). CK-MK, cTnI and NT-proBNP were negatively correlated with SDNN, SDANN, RMSSD and pNN50, and positively correlated with LF/HF (P<0.05). The AUC of CK-MK, cTnI, NT proBNP, SDNN, SDANN, RMSSD, pNN50 and LF/HF in predicting the prognosis of patients with AMI was 0.914, which was higher than that of single prediction. HRV parameters of ECG are related to myocardial injury in patients with AMI, and the combination of these parameters can be used as an important means to predict prognosis and provide basis for clinical practice.

Key words: electrocardiogram (ECG), heart rate variability, acute myocardial infarction, myocardial injury, prognosis

辛晓文, 董艳妮, 孙凌云. 心电图心率变异性参数与AMI患者心肌损伤的关系及联合预测预后分析[J]. 影像科学与光化学, 2021, 39(5): 625-630.

XIN Xiaowen, DONG Yanni, SUN Lingyun. The Relationship between Heart Rate Variability Parameters of Electrocardiogram and Myocardial Injury in Patients with AMI and Analysis of Joint Predictive Prognosis[J]. IMAGING SCIENCE AND PHOTOCHEMISTRY, 2021, 39(5): 625-630.

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