冠状动脉支架植入术对急性冠脉综合征患者心率变异性的影响

Effect of stent implantation on the heart rate variation in patient with acute coronary syndrome

目的探讨急性冠脉综合征（ACS）患者冠状动脉狭窄对心率变异性（HRV）的影响。观察经皮冠状动脉介入术（PCI）后HRV变化,评估PCI对ACS预后的影响。方法选择我科2007年2月～2010年2月经PCI术的ACS患者106例,应用24小时动态心电图于支架术前/术后1周及3个月分别检测HRV时域指标和频域指标,并进行对比分析。结果 PCI术后1周SDNN、SDANN、PNN50、LF及HF较术前无明显变化（P〉0.05）,而术后3个月患者HRV的时域指标和频域指标即SDNN、SDANN、PNN50、LF、rMSSD、HF较术前明显增高（P〈0.01）。结论 PCI可以改善ACS患者的心率变异性,可能与PCI改善了患者的心肌缺血及纠正神经体液因子对窦房结功能、心室肌功能的调控失衡有关。

Aim To intvestigate the heart rate variation（HRV） in patients with acte coronary syndrome（ACS） after stent implantation and evaluate the effect of stent implantation on the self nerve systen function.Methods The stent implantation were performed from Oc-tober 2007 to October 2009 on 106 patients with ACS.There HRV（time domain and frequency domain） were analyzed with Holter be-fore,a week and three months after stents implantation.Results There were no significant difference in SDNN,SDANN,PNN50,LF af-ter a week of PCI.（P 〉0.05）.The index of time domain and frequency domain increased significantly after three months of PCI（P〈 0.01）.Conclusions HRV in patients with ACS can be significant after stentsim plantation,and it may be related to improvement of my-ocardial circulation,and the correction of the dysfunction of sinus node and myocardium due to the unbalance of neuro humoral factors.