性行为对急性心肌梗塞恢复期患者心肌缺血、心律失常及心率变异性的影响

Influence of sexual activity on myocardial ischemia, arrhythmia and heart rate variability in patients after acute myocardial infarction

目的 探讨急性心肌梗塞恢复期患者行性行为的可行性和安全性。方法 对 4 4例心肌梗塞恢复期 ( 19～ 4 2天 )男性患者采用运动试验、动态血压、动态心电图、心率变异性分析 ,研究性行为对心肌缺血、心律失常及心率变异性的影响 ,并与 15例健康男性作为对照组进行比较。结果 在性行为高峰时最大平均心率和最大平均血压二组差异无显著性。在心肌梗塞患者组有一例发生再次心肌梗塞 ;5例 ( 11% )发生与性行为有关的室性心律失常 ,在窦性心搏间期的标准差 (SDNN) <5 0ms的患者性交高峰后均易发生复杂型心律失常。结论 急性心肌梗塞恢复期行性行为是可行的 ,较安全的 ,但SDNN <5 0ms及不能耐受Bruce改良方案一级末或运动诱发复杂型心律失常者 ,作性行为将是危险的。在性行为时当患者伴有短暂的心肌缺血及心率快、血压高时 ,若服用β 受体阻断剂可以增加性行为耐力。

Objective To study the feasibility and safety of sexual activity in patients after acute myocardial infarction (AMI) Methods By exercise test, ambulatory blood pressure monitoring (ABM), dynamic eletrocardiography (DCG), and heart rate variability analysis, the influence of sexual activity on myocardial ischemia, arrhythmia and cardiac function was studied in 44 male patients 19 44 (mean 35±8 4) days after AMI and 15 normal men Results The maximal average heart rate and mean systolic pressure had no significant difference between the two groups during peak of intercouse In the AMI group, one patient had recurrent AMI, 5(11%) patients had ventricular arrhythmia related to sexual activity and patients with SDNN<50 ms had complex arrhythmia easily evoked after peak of intercouse Conclusion Sexual activity is feasible and relatively safe for patients after AMI, but for those with SDNN <50 ms and intolerable to the end of grade I of Bruce improved plan or have complex arrhythmia during exercise test, sexual activity is dangerous Patients with temporary mycardial ischemia, high heart rate and high blood pressure should use β blocker to increase sexual tolerance