急性冠状动脉综合征患者窦性心率震荡的临床意义

Clinical significance of heart rate turbulence in patient with acute coronary syndrome

目的探讨急性冠状动脉综合征患者窦性心率震荡(HRT)现象的临床意义。方法分析比较34例急性冠状动脉综合征患者(冠脉组)与48例非器质性心脏病患者(对照组)的窦性心率震荡的起始值(TO)和震荡斜率(TS)。结果冠脉组TO(0.32±4.67)、TS(13.24±15.25)与年龄、性别均无相关性(P均>0.05),TS与左心室射血分数(58.4%±13.9%)有高度相关性(P<0.01)。对照组TO(-2.19±4.51)与年龄、性别均无相关性(P>0.05),TS(13.65±13.34)与年龄有高度相关性(P<0.01)。冠脉组TO、TS及TO+TS异常率较高,与对照组差异有非常显著性意义(P<0.01)。结论急性冠状动脉综合征患者窦性心率震荡现象减弱或消失,这一检测对急性冠状动脉综合征高危患者具有预测价值。

Objective Explore chang of heart rate turbulence （HRT） in patient with acute coronary syndrome and its clinical significance. Methods Both 34 patients with acute coronary syndrome （the coronary group） and 48 patients without organic cardiopathy （the controls group） are accepted 24-hour Hoher checks. Threshold （TO） and turbulence slope （TS） of HRT are calculated respectively, compared between groups and correlation analysis are also done respectively. Results TO was 0.32 ＋ 4.67 in ACS group and -2.19 ＋ 4.51 in control group, both of them were not associated with age and gender （P〉0.05）. In ACS group, TS was 13.24 ＋ 15.25 and was significantly related to left ventricular ejection fraction（58.4% ＋ 13.9%） （P〈0.01）. In control group, TS was 13.65 ＋ 13.34 and significantly related to age （P〈0.01 ）. Abnormality of TO, TS and TO ＋ TS was significantly more in ACS group than in control group （P〈0.01）. Conclusion Heart rate turbulence in patient with acute coronary syndrome weakened or dentirely missing . heart rate turbulence has predictive value on the dignosis of patient with acute coronary syndrome.