冠状动脉支架植入术后对冠心病患者心率变异性的影响

目的:观察冠心病患者冠状动脉支架植入术后心率变异性(HRV)变化,评估支架植入术后对患者自主神经功能的影响。方法:选择我科2005年1月-2007年1月经支架安置术的患者67例,应用24h动态心电图于支架术前、术后7d、6个月分别检测HRV时域指标和频域指标并进行对比分析。结果:支架术后7d SDNN、SDANN、PNN50、TI、LF及LF/HF较术前无明显变化(P>0.05)。而术后6个月患者HRV的时域和频域指标即SDNN、SDANN、PNN50、TI、LF及LF/HF较术前明显增高(P<0.01)。rMSSD、HF差异无显著性(P>0.05)。结论:支架植入术后近期心率变异性无明显改善;6个月后冠心病患者的心率变异性有明显增高,可能与冠状动脉内支架植入后有效地改善心肌缺血、恢复心脏自主神经的平衡有关。

The Effects of Stent Implantation on the Heart Rate Variation in Patients with Coronary Heart Disease

Objective： To observe the heart rate variation （HRV） in patients with coronary heart disease after stent implantation and evaluate the effect of stent implantation on the self nerve system function. Methods： The stenl implantations were performed from January, 2005 to 2007 on 67 patients with coronary heart disease. Their HRV （time domain and frequency domain） were analyzed before, and 7days and 6 months after stents implantation. Results： There were no significant difference in SDNN, SDANN, PNNs0, TI, LF and LF/HF before and after stents implantation （P〉0. 05）. The index of time domain and frequency domain, as SI）NN, SI）ANN, PNN50, TI, LF and LF/HF increased significantly after stent implantation（P〈0. 01）. There was no significant difference in rMSSD and HF. Conclusion： There was no significant improvement in HRV shortly after stent implantatiom. HRV improved markedly in patients with coronary heart disease 6 months after the performance. This phenomenon may be related to the improvement of cardiac ischemia and the recovery of the self cardiac nerve equilibrium.