经皮冠状动脉介入治疗对急性心肌梗死患者近期心率震荡的影响

Effect of percutaneous coronary intervention on late heart rate turbulence in patients with acute myocardial ischemia

目的探讨急性心肌梗死(AMI)后,直接经皮冠状动脉介入治疗(PCI)与延迟冠状动脉介入治疗对近期心率震荡(HRT)的影响。方法对首次发生AMI并于发病6 h内行直接PCI治疗的37例患者和同期因AMI入院而行延期PCI治疗的176例患者,于PCI术后1 h内开始连续72 h心电监护,第1周、第6周进行动态心电图监测,记录发生的室性期前收缩情况,分别计算HRT的震荡初始(TO)和震荡斜率(TS)值,对结果进行比较。结果2组不同观察时间的TO、TS值存在显著性差异(P<0.05)。结论对于AMI患者,直接PCI可明显改善患者的HRT,提示可改善和恢复AMI患者心脏自主神经系统的平衡,从而降低AMI后发生恶性心脏事件的危险性,在这方面的作用优于延迟PCI。

Objective It is to explore the effect of direct percutaneous coronary intervention（PCI） and delayed PCI on late heart rate turbulence （HRT） in patients with acute myocardial ischemia（AMI）. Methods 37 cases of patients with AMI accepted direct PCI within 6h after onset, and 176 cases of ones accepted delayed PCI were given 72 h continual electrocardioguardianship in lh after PCI, and were given dynamic electrocardiogram guardianship in 1 week and 6 weeks. Occurrences of remature ventrieualr contraction were recorded and TO and TS values were calculated. After that, the results were compared with each other. Results The were significant differences in TO and TS in different observing time（ P 〈 0.05）. Conclusion Direct PCI can obviously improve HRT of the patients with AMI which reveals that it can improve and recovery the balance of heart autonomic nervous system of patients with AMI, so to decrease the danger of malignant heart incidents. This function of direct PCI is better than that of delayed PCI.