摘要
目的评价窦性心率震荡(HRT)在急性冠脉综合征(ACS)患者危险分层中的作用。方法对213例ACS患者,其中包括急性心肌梗死(AMI)组86例和不稳定型心绞痛(UAP)组127例,以及健康对照组100例进行24 h动态心电图检查,计算HRT指标,根据全球急性冠状动脉事件注册(GRACE)危险评分将ACS患者分为低危、中危和高危,比较各组HRT指标的差异和HRT异常发生率。结果 3组震荡初始(TO)、震荡斜率(TS)间差异均有统计学意义(P<0.05);AMI、UAP组TO高于对照组,TS低于对照组,差异均有统计学意义(P<0.05)。AMI组和UAP组患者不同危险分层的TO、TS间差异均有统计学意义(P<0.05),其中高危组与中、低危组比较,TO增大,TS减小,差异均有统计学意义(P<0.05)。AMI组和UAP组患者不同危险分层的HRT2异常发生率间差异均有统计学意义(P<0.05)。多变量Cox回归分析显示,TO、TS对AMI和UAP的影响差异均有统计学意义(P<0.05)。结论TO、TS是ACS患者发生心源性死亡的独立危险因素,HRT可作为ACS危险分层的新指标。
Objective To evaluate the role of sinus heart rate turbulence （HRT） in risk stratification of patients with acute coronary syndrome （ACS） . Methods A total of 213 patients with ACS including 86 patients with acute myocardial infraction （AMI） and 127 patients with unstable angina pectoris （UAP）, and 100 healthy controls were enrolled in this study. All subjects were measured with 24 h dynamic electrocardiogram and indicators of HRT were calculated. According to GRACE sco- ring, the ACS patients were further divided into low - risk group, medium - risk group, and high - risk group. The indexes of HRT and incidence of abnormal HRT among the three groups were compared. Results The AMI group and UAP group had significantly higher Turbulence onset （TO） and lower turbulence slope （TS） than the healthy control group （P 〈 0. 05 ）. In AMI group and UAP group, high - risk subgroup had increased TO and decreased TS than the low - risk group and medium - risk group （P 〈 0. 05 ）. Incidence of abnormal HRT2 varied with risk stratification in AMI and UAP groups （P 〈 0. 05 ）. The multivariate Cox regression analysis showed that TO and TS were the independent risk factors for cardiac sudden death. Conclusion HRT may be a new indicator for ACS risk stratification.
出处
《中国全科医学》
CAS
CSCD
北大核心
2013年第19期2227-2229,共3页
Chinese General Practice
基金
佛山市卫生局医学科研基金项目(2006039)
关键词
窦性心率震荡
急性冠脉综合征
危险分层
心电描记术
Sinus heart rate turbulence
Acute coronary syndrome
Risk stratification
Electrocardiography
