113例急性心肌梗死心率变异性与恶性心律失常相关性的研究

To study the relationship between heart rate variability and malignant arrhythmia in 113 cases of acute myocardial infarction

目的:探讨急性心肌梗死(AMI)患者的心率变异性(HRV)情况与恶性室性心律失常发生率及猝死率的相关性,预测AMI患者的病情及预后。方法:对113例已确诊AMI患者进行24 h动态心电图检查,对HRV进行时域分析(主要参数为全部正常窦性心动周期的标准差-SDNN),监测恶性室性心律失常的发生率,然后随访患者1年。结果:SDNN<50 ms,预测高危险水平的患者31例;SDNN介于50 ms～100 ms,预测中危险水平患者36例;SDNN介于100 ms～150 ms,预测低危险水平患者46例。高危险水平患者组发生恶性室性心律失常19例,猝死6例;中危险水平患者组发生恶性室性心律失常9例,猝死1例;低危险水平患者组发生恶性室性心律失常5例,无猝死。3组患者恶性室性心律失常发生率比较,P<0.05,心脏猝死率比较,P<0.01。结论:HRV减小程度与恶性室性心律失常及猝死发生率有正相关性,HRV在预测AMI患者的危险性及预后起着重要作用。

Objective：To study the relationship between heart rate variability（HRV） and malignant ventricular arrhythmia and sudden death in acute myocardial infarction（AMI） patients and the pathogenetic condition and prognosis.Methods：To study time domain analysis of HRV（the main parameter： SDNN） and the incidence rate of malignant ventricular arrhythmia with Holter monitoring in 113 cases of AMI,and then follow up one year.Results：31 cases as high risk group（SDNN〈50ms）,36 cases moderate risk group（SDNN 50-100 ms） and 46 cases low risk group（SDNN 100-150 ms）.The amount of malignant ventricular arrhythmia and sudden death were 19 cases and 6 cases in high risk group,9 cases and 1 cases in moderate risk group,5 cases and 0 cases in low risk group.The incidence rate of malignant ventricular arrhythmia and sudden death in 3 group was significant（P〈0.05 and P〈0.01）.Conclusion：There were direct correlation between HRV and malignant ventricular arrhythmia and sudden death in AMI.HRV is important to estimate the risk and prognosis in AMI.