摘要
目的探讨窦性心率震荡(HRT)各指标与冠状动脉病变的相关性及经皮冠状动脉腔内成形术(PTCA)对其影响。方法选择150例患者进行冠状动脉造影(CAG)和24h动态心电图(AECG)监测,对CAG阳性组于PTCA术后第1天和第7天进行AECG监测并随访观察心功能与HRT的关系,分别计算各阶段HRT的震荡初始(TO)、震荡斜率(TS)和震荡斜率起始时间(TT)值。结果CAG阳性组TO和TT值显著高于阴性组(P<0.05或0.001),TS显著低于阴性组(P<0.001);冠状动脉多支病变组TO和TT显著高于单支病变组(P<0.05或<0.001),而TS显著低于单支病变组(P<0.001);PTCA术后第1天单支或多支病变组TO、TS和TT均较术前明显改善(P<0.001),术后随访左心功能不全组HRT现象均较无左心功能不全组明显减弱(P<0.05或<0.001)。结论HRT与冠状动脉病变程度相关,PTCA术后HRT明显改善,后期的心功能不良是影响HRT现象减弱的重要因素之一。
Objective To investigate the correlation between heart rate turbulence （HRT） and coronary lesion and the effects of percutaneous transluminal coronary angioplasty （PTCA） on HRT. Methods This study involved 150 patients undergoing 24-hour ambulatory electrocardiograply （AECG） and elective coronary angiography （CAG）. AECG was monitored on the first day and 7 days after PTCA in 108 patients with positive CAG findings, and the variation of HRT and cardiac functions were observed. The turbulence onset （TO）, turbulence slope （TS） and turbulence timing （TT） of each section of HRT were calculated, analyzed and compared. Results The values of TO and TT were significantly higher and TS significantly lower in CAG-positive group than in CAG-negative group （P〈0.05 or 0.001）. Significant difference was found in TO, TS and TT between patients with single and multiple coronary lesions （P〈0.05 and 0.001）. The values of TO, TS and TT on the first day after PTCA improved significantly in comparison with the those before PTCA in patients with single and multiple coronary lesions （P〈0.001）. Postoperative follow-up of the patients revealed obviously attenuated HRT in patients with left cardiac insufficiency compared with the patients with normal cardiac fimction （P〈0.05）. Conclusion HRT is correlated to the severity of the coronary lesions and shows significant improvement after PTCA. Cardiac function insufficiency is an important factor affecting the HRT attenuation.
出处
《南方医科大学学报》
CAS
CSCD
北大核心
2009年第3期516-518,共3页
Journal of Southern Medical University
基金
佛山市医学科学技术研究基金(2006039)
关键词
冠状动脉疾病
心率震荡
动态心电图
经皮冠状动脉腔内成形术
冠状动脉造影
coronary disease
heart rate turbulence
ambulatory electrocardiograph
percutaneous transluminal coronary angioplasty
coronary angiography
