冠心病不稳定型心绞痛心率震荡的临床分析

Analysis of heart rate turbulence in patients with unstable pectoris angina

目的:探讨不稳定型心绞痛(UPA)患者24 h动态心电图中恶性室性心律失常与心率震荡(HRT)的关系。方法:选择有室性早搏的患者,分为不稳定心绞痛组和对照组,其中66例不稳定心绞痛患者又分为恶性心律失常组和对照组进行亚组分析。所有患者人均行24 h动态心电图监测,计算心率震荡的初始值(TO)、斜率(TS)以及室性心律失常的数目、形态。结果:UPA组TO>0,对照组患者TO<0;UPA患者的TS明显低于对照组患者。亚组分析,UPA患者中恶性心律失常组与对照组对比,TO、TS均有明显异常。结论:HRT降低可作为预测UPA恶性室性心律失常发生的指标之一,可作为UPA判断预后的重要指标。

Objective. To study the relationship between malignant ventricular arrhythmia and heart rate turbulence （HRT） of 24hrs ambulatory electrocardiogram in patients with unstable pectoris angina （UPA）. Methods. Patients with premature ventricular beat were divided into UPA group and control group, of 66 patients with UPA were investigated by dividing into malignant ventricular arrhythmia group and control group again. All patients were examined with ambulatory electrocardiogram monitoring for twenty-four hours, and amount and shape of ventricular arrhythmia, turbulence onset （TO） and turbulence slope （TS） were analyzed. Results, TO was higher than zero in UPA group and lower than zero in control group, TS in UPA group was lower than that in control group. TO and TS had significant difference in malignant ventricular arrhythmia subgroup of UPA group compared to its control group. Conclusion： Lower HRT could be a predictive and prognostic index for malignant ventricular arrhythmia in patients with UPA.