经皮冠状动脉介入对心脏自主神经的影响

Effect of percutaneous coronary intervention on cardiac autonomic nervous system

目的:探讨经皮冠状动脉介入治疗(PCI)后心脏心率变异性(HRV)及QT离散度(QTd)的长期动态变化规律。方法:冠心病组32例,选择经冠状动脉造影证实并适合PCI的冠心病患者;对照组32例,选年龄性别匹配的经皮冠状动脉造影证实的非冠心病患者。所有入选者于PCI前,术后1周、1个月、3个月、6个月及1年进行HRV及QTd检测。结果:冠心病组HRV减低,PCI后1周HRV较术前减低更为明显,术后1,3个月HRV逐步升高,于6个月较术前改善最为明显,术后1年几乎达对照组水平;PCI前QTd较对照组明显增大,术后1周较术前缩小,1个月后明显缩小,以后变化不明显。结论:冠心病患者QTd增大,HRV减低,心脏自主神经功能受损。PCI后QTd短期内明显缩小,心脏自主神经功能PCI后早期进一步受损,但远期明显改善。

Objective：To investigate the long-term effect of percutaneous coronary intervention（PCI） on heart rate variability （ HRV） and QT dispersion in patients with coronary artery disease（CAD）. Method： There were 32 patients confirmed by coronary angiography and suitable for PCI in CAD group, and another 32 cases whose age and gender matched without CAD in control group . HRV indices and QT dispersion were analyzed before PCI and 1 week, 1 month, 3 months, 6 months, 1 year after PCI. Result： HRV indices were decreased in patients with CAD before PCI. and it was further lower at 1 week after PCI. Then it was gradually increased at 1 month and 6 months after PCI, and nearly to the level of persons with non-CAD at 1 year after PCI. QT dispersion was longer in patients with CAD than those with non-CAD, and it was shorter at 1 week after PCI but significantly decreased at 1 month after PCI, with no change after 1 year of PCI. Conclusion： HRV was decreased and QT dispersion was longer in the patients with CAD. QT dispersion was immediately decreased after PCI. HRV was slightly decreased in the early stage of PCI, but the long effect of PCI on heart rate variability could be observed.