急性心肌梗死患者梗死相关血管与心率变异性的相关性研究

A correlation study about the infarct-related arteries( IRA) of patients with acute myocardial infarction( AMI)and heart rate variability( HRV)

目的探讨急性心肌梗死(AMI)患者心率变异性(HRV)及其与梗死相关血管(IRA)的相关关系。方法对68例AMI患者和80例正常人行24 h动态心电图(Holter)检查,测量并计算HRV时域指标与频域指标:24 h连续正常R-R间期的标准差(SDNN)、24 h连续5 min节段平均正常R-R之间期标准差(SDANN)、24 h内相邻的R-R间期差值的均方根(RMSSD)、两个相邻R-R间期差>50 ms心率数的百分比(PNN50%)、低频(LF)成分、高频(HF)成分及低频与高频比(LF/HF)以及LF与HF的对数值LnLF和LnHF,比较AMI组与正常对照组HRV指标的变化。在上述研究的基础上,进一步分析与比较AMI组梗死相关血管左冠状动脉(LCA)与右冠状动脉(RCA)病变患者的HRV各项指标变化。结果与正常对照组相比较,AMI组HRV相关参数SDNN、SDANN、LnLF和LF/HF均明显减低;与RCA病变心肌梗死组相比较,LCA病变心肌梗死组的SDNN、SDANN、RMSSD、PNN50和LnLF降低显著。结论急性心肌梗死患者的HRV各项参数较正常人降低,尤其是LCA病变所致的心肌梗死远较RCA病变心肌梗死患者HRV降低更加明显。

Objective To explore the heart rate variability（HRV） of patients with acute myocardial infarction（AMI） and the correlation of AMI patients＇ HRV and different infarct-related arteries （IRA）. Methods The 24-hour ambulatory electrocardiogram（Hoher） was carried out in 68 cases of AMI patients and 80 cases of healthy people. The time-domain indexes and frequency-domain indexes were measured and calculated, which includedstandard deviation of normal number of intervals （SDNN）, standard deviation per 5 min averages normal number of intervals（ SDANN）, root means square values of the standard deviation between adjacent normal number of intervals （RMSSD）, percentage of NNSO in the total number of NN intervals（PNNSO） ,low frequency（LF） ,high frequency（HF） ,the ratio of LF to HF（LF/HF） and the log Kow of LF and HF （ LnLF and LnHF）. The differences of HRV parameters among AMI group and control group were analyzed. Based on the above research results, the differences of HRV parameters between the left coronary artery （LCA） patients and the right coronary artery （RCA） patients in AMI group were further analyzed and compared. Results Compared to the control group, HRV indexes of AMI group, such as SDNN, SDANN, LnLF and LF/HF, were significantly lower. Similarly, compared to the RCA group of AMI patients, SDNN, SDANN, RMSSD, PNN50 and LnLF of the LCA group were significantly lower. Conclusion The HRV parameters of patients with AMI were lower than those of normal person. In parti- cular,reduced heart rate variability was associated with infarct-related artery of myocardial infarction. The HRV parameters of AMI patients resulted from LCA lesion were far more reduced than those of AMI patients caused by RCA lesion.