摘要
目的通过对急性心肌梗死(AMI)组和对照组及AMI组内研究,确立对AMI高危患者有预测价值的新指标。方法选择发病3～4周的72例AMI患者和76例年龄、性别匹配的正常人分别作为AMI组和对照组。收集入选者的临床资料,获取心率震荡(heart rate turbulence,HRT)、心率变异性(HRV)、QT间期变异度(QTV)、QT间期变异系数(QTCV)和左心室射血分数(LVEF)等指标。定量测量HRT包括震荡初始(turbulence onset,TO)和震荡斜率(turbulence slope,TS)两个指标。AMI组内分为AMI高危组和低危组。结果TS在AMI组明显低于对照组(P＜0．01),高危组低于低危组(P＜0．05)；各指标之间差异无统计学意义(P＞0．05)；生存分析结果显示TS与TO TS相结合都对发生终点事件的患者有贡献(P＜0．05),而TO、TS相结合是预测价值最高的指标(相对危险度为2．984),远远高于LVEF(0．208)及其他指标。结论组间比较和生存分析均证明HRT的预测价值优于众多传统指标,推断HRT可能成为评价AMI患者自主神经功能状态、独立预测AMI高危患者的新指标。
Objective To obtain some index signs to predict high-risk patients after acute myocardial infarction（AMI）. Methods Seventy-two patients with AMI in 3 - 4 weeks and seventy-six health controls were enrolled. Heart rate turbulence（HRT） including turbulence onset （TO）and turbulence slope （TS）, heart rate variability（HRV） ,QT interval variability （QTV）, coefficient of QT interval variation （QTCV） and left ventricular ejection fraction （LVEF） were collected. AMI patients were divided into two groups： high-risk group and low-risk group. Results TS was significantly lower in patients with AMI than compared to controls （P 〈0.01）and in highrisk patients compared to low-risk patients（P 〈0. 05）. There was no correlation between TO,TS, HRV, QTV,QTCV and LVEF in patients with AMI and controls（P 〉0. 05）. Survival analysis indicated that TS and combination of TO and TS contributed to the end-point accident in patients with AMI. The combination of abnormal TO and abnormal TS （RR =2. 984） was more powerful in multivate risk stratifier than LVEF（RR =0. 208） and others. Conclusions. Survival analysis and comparison between groups demonstrated that HRT is a predictor better than other traditional factors. HRT may become a new and independent predictor of high-risk patients after AMI.
出处
《中华心律失常学杂志》
2006年第3期223-227,共5页
Chinese Journal of Cardiac Arrhythmias
关键词
心率震荡
急性心肌梗死
左心室射血分数
QT间期变异度
心率变异性
Heart rate turbulence
Acute myocardial infarction
Left ventricular ejection fraction
QT interval variability
Heart rate variability
