经皮腔内冠状动脉成形术对心肌梗死患者心率变异性和QT离散度的影响

The influence of percutaneous transluminal coronary angioplasity on heart rate variability and QT dispersion in patients with myocardial infarction

目的 通过对 2 2例心肌梗死 (MI)病人经皮腔内冠状动脉成形术 (PTCA)术前 ,术后心率变异性 (HRV)和 QT离散度 (QTd)的变化及其之间相关分析 ,来了解 PTCA术对心脏自主神经功能和心肌电稳定性的影响。结果 PTCA术后 HRV指标中 UL FP(193.4± 32 1.8;381.3± 6 35 .3) ,VL FP(35 2 .4± 40 4.5 ;6 82 .1± 5 72 .4) ,L FP(2 6 3.9± 2 30 .6 ;40 6 .7± 376 .4) ,TP(895 .6± 795 .8;1817.5±16 85 .3) ,HRm ean(6 8.1± 9.7;74.7± 11.6 ) ,HRmax(76 .4± 11.6 ;82 .6± 11.8) ;HRm in(6 2 .2± 9.5 ;6 8.3± 12 .1)明显升高 (P<0 .0 5 ) ,而 QTd(80 .5± 18.2 ;5 3.5± 13.9)和 QTcd(85 .5± 19.4;6 0 .2±14.5 )则明显减少 (P<0 .0 5 )。术前、术后 QTd、QTcd与 HRV指标之间有相关关系。说明心肌梗死病人PTCA术后心脏自主神经调节能力和心肌电稳定性明显提高 ,提示 PTCA术可能改善心梗病人的预后。

The purpose of this study was to determine if PTCA of the infarct related coronary artery(IRA) in the late phase of myocardial infarction (MI) can improve autonomic regulation of sinus rhythm and electrical stability of the myocardium measured by heart rate vaniability(HRV),QT dispersoion(QTd) and QTcd and if any correlation exists among these measures.Results Parameters of HRV were significantly higher after successful PTCA:ULFP(193 4±321 8 VS 381 3±635 3),VLFP(352 4±404 5 VS 682 1±572 4),LFP(263 9±230 6 VS 406 7±376 4),TP(895 6±795 8 VS 1817 5±1685 3),HRmean(68 1±9 7 VS 74 7±11 6),HRmax(76 4±11 6 VS 82 6±11 8);HRmin(62 2±9 5 VS 68 3±12 1).QT dispersion (80 5±18 2 VS 53 5±13 9) and QTcd(85 5±19 4 VS 60 2±14 5) were significantly lower after PTCA.There was correlation between QT values and HRV before and after PTCA.The study indicates that PTCA of IRA in the late phase of MI enhances sympathovagal regulation of the cardiac rhythm and the electrical stability of the heart,which may be prognostically important.