康复期老年心肌梗死患者心率变异性分析及其临床价值

Analysis of Heart Rate Variability in Elderly Patients with Myocardial Infarction during Rehabilitation and Its Clinical Value

目的研究康复期老年心肌梗死患者的心率变异性及其临床价值。方法随机选择该院2016年1—12月治疗的50例处于康复期的老年心肌梗死患者(观察组)和同期在该院健康体检的50名非心肌梗死者(对照组)为研究对象,采用时域测定法连续记录24 h动态心电图,观察并比较两组观察对象的心率变异性。结果观察组患者SDNN、SDANN、SDNNIndex、PNN50和RMSSD的观测值分别为(77.32±25.85)ms、(64.48±22.67)ms、(30.61±13.87)ms、(4.84±2.22)和(22.81±12.48),对照组的观测值分别为(136.11±27.14)ms、(125.28±23.54)ms、(54.23±15.65)ms、(8.80±2.58)和(30.76±13.87),两组研究对象的相应心率变异性检测指标之间的差异有统计学意义(P<0.05)。结论心肌梗死后病情稳定后,仍存在交感神经、迷走神经失衡的状态,存在严重的心律失常和猝死发生率。康复期老年心肌梗死患者心率变异性分析在其康复计划和措施的制定中具有重要的临床价值。

Objective To study the heart rate variability and clinical value of elderly patients with myocardial infarction during rehabilitation. Methods From January to December 2016, 50 cases of elderly patients with myocardial infarction who were treated in our hos-pital were selected as the observation group and 50 cases of patients with non-myocardial infarction enrolled in our hospital at the same period were selected as the control group. The time-domain method was used to record 24 h dynamic electrocardiogram and the heart rate variability of the two groups was observed and compared. Results The observation values of SDNN, SDANN, SDNN Index,PNN50 and RMSSD in the observation group were：（77.32±25.85） ms,（64.48±22.67） ms,（30.61±13.87） ms,（4.84±2.22） and（22.81±12.48）, respectively, and the control group＇s observation values were（136.11 ±27.14） ms,（125.28 ±23.54） ms,（54.23 ±15.65） ms,（8.80±2.58） and（30.76±13.87）. There were significant differences between the two groups in the indexes of heart rate variability（P〈0.05）. Conclusion There is still a state of sympathetic and vagal imbalance after the stability of myocardial infarction, and the inci-dence rate of arrhythmia and sudden death is severe, and the analysis of heart rate variability in elderly patients with myocardial in-farction during rehabilitation has an important clinical value in making the rehabilitation programs and measures.