老年急性心肌梗死心率变异的临床观察

Clinical observation of heart rate variability in elderly patients with acute myocardial infarction

目的探讨老年急性心肌梗死患者心率变异(HRV)与急性心肌梗死(AMI)预后及死亡的关系。方法应用24h动态心电图(Holter)检测52例老年急性心肌梗死患者的HRV各项时阈指标,总体标准差SDNN、均值标准差SDANN、标准差均值SDNNIDX、差值均方的平方根rMSSD、差值>50ms的百分比(PNN50)。将AMI后2.5年内因心源性死亡人数与存活人数分为死亡组与存活组进行对比。结果死亡组与存活组比较,SDNN、SDANN、SDNNIDX、rMSSD均明显降低(P<0.05)。结论老年急性心梗患者心率变异性越大,AMI预后越差,死亡率越高。

Objective To investigate the relation between heart rate variability （HRV） and mortality after acute myocardial infarction （AMI） in elderly patients. Methods The parameters of HRV and heart rate （HR） were determined by 24-hour ambulatory electrocardiography in 52 elderly patients with AMI. According to the prognosis within 2.5 years after AMI, the patients were divided into 2 groups, the AMI death group with 10 cases and the survivor group with 40 cases, and two cases that died of non-AMI causes were excluded. Results The values of SDNN、SDANN、SDNNIDX、 rMSSD in the death group were lower than those in the survivor group （P〈0.05）, but the value of PNN50 showed no significant difference. Conclusion The serious dysfunction in automatic nerves system in elderly patients with AMI might indicate a bad prognosis.