摘要
目的 探讨急性心肌梗死患者窦性心率震荡的临床价值.方法 选取86例急性心肌梗死患者（心肌梗死组）和60例有室性期前收缩的健康体检者（非心肌梗死组）进行24 h动态心电图监测,比较两组室性期前收缩后的震荡初始（TO）和震荡斜率（TS）.结果 心肌梗死组T0高于非心肌梗死组（P＜0.01）;TS低于非心肌梗死组（P＜0.01）.死亡组TO高于非死亡组（P＜0.05）,TS低于非死亡组（P＜0.05）.心肌梗死组中TO异常50例（58.1%）,TS异常58例（67.4%）,非心肌梗死组分别为10例（16.7%）和6例（10.0%）,两组比较差异均有统计学意义（P＜0.05）.T0和TS均异常的52例中死亡24例（46.2%）,TO或TS异常的28例中死亡7例（25.0%）,TO和TS均正常的6例中死亡1例（16.7%）,三种情况病死率比较差异有统计学意义（P＜0.01）.结论 急性心肌梗死患者窦性心率震荡现象减弱或消失时病死率增高,及时监测分析心肌梗死患者TO和TS对预测猝死高危患者及危险分层有重要临床价值.
Objective To explore the clinical utility of the sinus rhythm turbulence in the patients with acute myocardial infarction （AMI）. Methods All day the dynamic electrocardiogram was monitored in 36 patients with AMI （AMI group） and 60 healthy subjects with ventricular premature beat （VPB） （control group）,the TO value and TS value after VPB was compared between two groups. Results The TO value after VPB in AMI group was higher than that in control group （P〈0.01）, the TS value after VPB in AMI group was lower than that in control group （P 〈 0.01）. The TO value in the non-survivors with AMI was higher than that in the survivors,while their TS value was lower with a significant difference （P〈 0.01）. The irregular positive rate of the TO value and the TS value in the patients with AMI was 58.1%（50/86） and 67.4%（58/86）, while that of the healthysubjects was 16.7%（10/60） and 10.0%（6/60） with a significant difference （P 〈 0.05）. The research from the follow-up visit of the selected patients in 2 years showed that death rate of the patients with both irregular TO and TS was 46.2% （24/52）, the death rate with either irregular TO or TS was 25.0%（7/28）, the death rate with both regular TO and TS was 16.7%（1/6）, and the difference of the three phenomenon was significant （P 〈 0.01）. Conclusion As long as the sinus rhythm turbulence of the patients with AMI disappears or declines,the death rate increases, and to monitor and analyze their TO and TS in time is helpful for us to avoid the sudden death of the patients and to discover the levels of their risks.
出处
《中国医师进修杂志》
2011年第10期37-39,共3页
Chinese Journal of Postgraduates of Medicine
关键词
心肌梗死
窦性心率震荡
Myocardial infarction
Heart rate turbulence
