204例无症状性心肌缺血患者心率变异性的分析

Heart Rate Variability Analysis of 204 Patients with Silent Myocardial Ischemia

目的 探讨老年冠心病患者无症状心肌缺血心率变异性的变化情况。方法 2 0 4例冠心病患者在日常生活状态下进行 2 4h三通道动态心电图监测 ,并详细记录日常活动和相关症状 ,同时对无症状心肌缺血进行心率变异性分析。结果 无症状心肌缺血与心绞痛均可引起心率变异性多个参数的减低 ,2 0 4例患者出现 82 3次心肌缺血 ,其中 6 2 4次为无症状心肌缺血 ,无症状心肌缺血组心率变异性及多个参数均低于有症状心肌缺血和正常对照组比后者降低幅度更大 ,P均 <0 .0 5。结论 三通道动态心电图是检测无症状心肌缺血心率变异性的有效方法 ,老年冠心病患者无症状心肌缺血心率变异性多个参数均低于心绞痛和正常对照组 ,提示无症状心肌缺血更易引起心血管事件的发生 。

Objective To study variety regular of heart rate variability(HRV) in silent myocardial ischemia(SMI).Methods 204 coronary artery disease(CAD) patients underwent 24 hours of Holter monitoring during unrestricted daily life and were asked to keep a detailed diary of their activities and symptoms.Ambulatory 24 hours ST segment monitoring was performed with a 3 channel dynamic electrocardiogram(Marquette serises 8500) and were measured with HRV in the same time.Results Both SMI and angina pectoris(AP) resulted in decreasing of indexes of HRV,the 204 patients displayed 823 episodes of ischemia,624(76%) of which were silent.Parameters of HRV in SMI group is more decreasing than those of AP and control groups respectively(p less than 0.05).Conclusion 3 channel dynamic electrocardiogram is a effective way to detect HRV.SMI which is more tendency to develop cardiovascular events in future,should be attached importance in clinic.