急性心肌梗塞患者心率变异性分析的临床意义

The Significance of Heart Rate Variability During the Acute Myocardial Infarction

前瞻性观察60例急性心肌梗塞（AMI）、12例不稳定性心绞痛及20例健康人的心率变异性（HRV）．结果：AMI组24小时正常RR间期标准差（SDNN）低于另两组．AMI患者亚组分析：非Q波性心肌梗塞、溶栓组、KillipⅠ级组及左室射血分数＞40％组的SDNN高于对应亚组．SDNN与24小时心率、CK－MB峰值及左室射血分数有关．随访期死亡8例，其SDNN明显低于存活者．SDNN＜50ms与死亡率有关．提示AMI患者HRV降低与患者的临床严重性及预后有关，可作为判断MAI患者预后的指标．

In this paper, heart rate variablity (HRV) was analysed in 60 patients with acute myocardinl infarction (AMI), 12 patients with unstable angina and 20 normal subjects. The results showed that the stanard deviation of 24 hour RR interval (SDNN) was lower in AMI than in unstable angina patients and controls. Also, HRV was greater in non-Q wave than in Q-wave AMI and in urokinase-threated patients with respect to the rest of the group. Patients belonging to killip class I had higher counts. 8 patients died during follow-up periods. In these patients, SDNN was lower than that in survivors, and a value <50 msec was signifcantly associated with mortality. It is suggested that HRV during the acute phase of MI is decreased and is significantly related to clinical indexes of severity and progosis. HRV during AMI may offer important clinical information and contrib ute to the early risk strtification of patients.