急性心肌梗死患者早期心率变异性与心功能的关系

Relationships between Cardial Rate Variability and Cardiac Function in Early Acute Myocardial Infarction

目的分析急性心肌梗死(AMI)患者极早期及稳定期心率变异性(HRV)、心肌酶与心功能的量化关系。方法选取发病24h内AMI患者30例,化验心肌酶谱测定肌酸激酶(CPK)及肌酸激酶同工酶(CK-MB)峰值。发病48h内及两周各行动态心电图检查测HRV各指标值。两周时行超声心动图测定左室射血分数(LVEF)。结果稳定期HRV各指标均与LVEF呈正相关,NN间期标准差(SDNN)、NN间期平均值的标准差(SDANN)、相邻NN间期差值超过50ms的心搏数占NN间期总心搏数的百分比(PNN50)、全程NN间期之差的平方根(RMSSD)、低频功率(LF)、高频功率(HF)的r值分别为0.77、0.80、0.56、0.56、0.66、0.59(P均<0.05);HRV指标SDNN、SDANN、LF其恢复程度与LVEF呈正相关(P<0.05);而极早期HRV与LVEF无相关性。CPK、CK-MB与LVEF呈明显负相关。稳定期与极早期比较HRV时域指标SDNN、SDANN明显恢复(P<0.01)。结论AMI患者稳定期的HRV及两周内HRV恢复程度可反映心功能状态。

Objective To assess the relationship between heart rate variability （HRV）, CPK and CK - MB and heart function in patients （pts） with early acute myocardial infarction （AMI）. Methods Thirty pts with AMI in 24 hours were selected. Myocardial enzyme was tested. HRV were measured in 48 hours after AMI and 2 weeks. LVEF were measured by echocardiography at 2 weeks. Results HRV was obvious positive correlation with LVEF. The r（relative coefficient） of SDNN, SDANN, PNNS0, RMSSD, LF and HF was 0.77, 0.80, 0.56, 0.56, 0.66 and 0.59, respectively（P〈50.05）. The degree of recovery of SDNN, SDANN, and LF showed obvious positive correlation with LVEF. The r of SDNN , SDANN and LF was 0. 5 9 , 0. 6 9 and 0. 5 4 , respectively （ P 〈5 0.05）. CK and CK - MB were negatively correlated with LVEF（r= -0. 738, -0. 7196,P〈50.01）. The SDNN and SDANN recovered obviously P〈50.01）. Conclusion The HRV in early stable period of AMI and the HRV at the two week were closely related to heart functions.