心率变异三角指数在心肌梗死患者预后评估中的应用价值

Assessment Value of Heart Rate Variability Triangular Index on the Prognosis of Patients with Myocardial Infarction

目的探讨心率变异三角指数在心肌梗死患者预后评估中的应用价值。方法选择2010年12月—2013年12月入住淄博市临淄区人民医院的心肌梗死患者50例作为心肌梗死组,另选择同期体检健康者50例作为对照组,采用美国GE十二导联动态心电图连续24 h进行心电监测及心率变异性分析,包括时域指标〔全部NN间期的标准差(SDNN)、每5 min平均值标准差(SDANN)、全程相邻NN间期之差平方根(RMSSD)、相邻NN间期差值>50ms百分比(PNN50)〕、频域指标〔低频功率(LF)、高频功率(HF)〕及心率变异三角指数。结果心肌梗死组患者SDNN、SDANN、心率变异三角指数、RMSSD、PNN50、LF及HF均低于对照组(P<0.05)。心肌梗死组患者发生心脏事件12例,发生率为24%,发生心脏事件患者SDNN、SDANN、心率变异三角指数、RMSSD、PNN50、LF及HF均低于未发生心脏事件患者(P<0.05)。心率变异三角指数>25 ms患者心脏事件发生率为13.8%(4/29),低于心率变异三角指数≤25 ms患者的38.1%(8/21)(P<0.05)。直线相关分析结果显示,心率变异三角指数与心脏事件发生率呈负相关(r=-0.471,P<0.05)。结论心率变异三角指数与心肌梗死患者心脏事件的发生有关,其对评估心肌梗死患者预后具有重要临床价值。

Objective To investigate the assessment value of heart rate variability triangular index（ HRVTI） on the prognosis of patients with myocardial infarction. Methods From December 2010 to December 2013,a total of 50 patients with myocardial infarction were selected as case group,and 50 healthy cases were selected as control group. GE 12 -lead dynamic＆amp;nbsp;electrocardiogram was used to monitor the 24-hour electrocardiographic changes and analyze the heart rate variability,including time domain index（including SDNN,SDANN,RMSSD,PNN50）,frequency domain index（including LF and HF）and HRVTI. Results SDNN,SDANN,RMSSD,PNN50,LF,HF and HRVTI of case group were statistically significantly lower than those of control group（P ﹤0. 05）. Of case group,12 cases occurred cardiac events,accounted for 24%;SDNN, SDANN,RMSSD,PNN50,LF,HF and HRVTI of patients complicated with cardiac events were statistically significantly lower than those of patient uncomplicated with cardiac events（P﹤0. 05）. The incidence of cardiac events of patients with HRVTI﹥25 ms was 13. 8%（4/29）,was statistically significantly lower than that of patients with HRVTI≤25 ms of 38. 1%（8/21）（P﹤0. 05）. Linear correlation analysis showed that,HRVTI was negatively correlated with the incidence of cardiac events（ r=-0. 471,P﹤0. 05 ）. Conclusion HRVTI is correlated with the incidence of cardiac events in patients with myocardial infarction,has important assessment valuein evaluating the prognosis.