不同部位急性心肌梗死患者的心律失常及心率变异性分析

Analysis on arrhythmia and heart rate variability in patients with acute myocardial infarction at different sites

目的研究不同部位急性心肌梗死(AMI)患者的心律失常表现特征及其心率变异性。方法纳入2015年1月至2016年6月就诊于兰卅大学第一医院的AMI患者,根据心电图结果分为非ST段抬高型心肌梗死(NSTEMI)组、下壁组及前壁组。分析各组住院期间动态心电图(DEC)资料,对比心律失常发生情况及心率变异性指标。结果共纳入239例AMI患者。在NSTEMI组、下壁组及前壁组间,频发室性早搏、Lown≥3级室性早搏及房性心律失常的发生率差异无统计学意义(P>0.05),但NSTEMI组和下壁组的缓慢性心律失常发生率高于前壁组,差异有统计学意义(P<0.05)。前壁组全部窦性心搏RR间期的标准差(SDNN)、RR间期平均值的标准差(SDANN)、RR间期标准差的平均值(ASDNN)均显著低于NSTEMI组和下壁组,差异有统计学意义(P<0.05)。结论与前壁心肌梗死相比,NSTEMI和下壁心肌梗死缓慢性心律失常发生率较高,但心率变异性损害程度较轻。

Objective To investigate the characteristics of arrhythmia and heart rate variability in the patients with acute myocardial infarction （AMI） at different sites.Methods A retrospective study was carried out on the AMI patients admitted to our hospital from January 2015 to June 2016.According to the result of electrocardiogram, they were divided into non-ST-segment elevation myocardial infarction （NSTEMI） group, inferior-wall group, and anterior-wall group.The dynamic electrocardiogram data during hospitalization was analyzed, and the arrhythmia and heart rate variability were compared among the groups.Results A total of 239 patients with AMI were enrolled.There were no significant differences in the incidences of frequent ventricular premature beats （VPB）, Lown＇s degree ≥3-stage VPB and atrial arrhythmia among the 3 groups （P〉0.05）.However, the NSTEMI and inferior-wall groups had obviously higher incidence of bradyarrhythmia than the anterior-wall group （P〈0.05）.The standard deviation of all normal R-R intervals （SDNN）, standard deviation of the average normal RR intervals（SDANN） and average of the standard deviations of normal RR intervals （ASDNN） were notably lower in the anterior-wall group than the other 2 groups （P〈0.05）.Conclusion Compared with anterior-wall AMI patients, NSTEMI and inferior-wall patients have higher incidence of bradyarrhythmia and reduced variability of heart rate.