经皮冠状动脉介入治疗对急性心肌梗死患者窦性心率震荡及心率变异性的影响

目的探讨经皮冠状动脉介入术（PCI）治疗急性心肌梗死（AMI）后对窦性心率震荡（HRT）和心率变异性（HRV）的影响。方法将150例急性心肌梗死患者分为直接PCI组、延迟PCI组和药物治疗组各50例,分别予直接PC、I延迟PC I和药物治疗。AMI后2~3周各组行动态心电图检查分析其HRT参数：震荡初始（TO）和震荡斜率（TS）,同时获取HRV指标：24 h时平均R-R间距的标准差（SDNN）,每5 min时间段R-R间距平均值的标准差（SDANN）。结果直接PCI组TO明显低于,TS、SDNN、SDANN明显高于延迟PC I组及药物治疗组（P均〈0.01）;延迟PCI组TO明显低于,TS、SDNN、SDANN明显高于药物治疗组（P均〈0.05）。结论直接或延迟PC I可有效地改善AMI心肌缺血,有利于防止恶性心律失常和心性猝死的发生;直接PC I效果更优。

Effects of percutaneous coronary intervention on sinus heart rate turbulence and heart rate variability in acute myocardial infarction patients

Objective To explore the effects of percutaneous coronary intervention（PCI） on the heart rate turbulence（HRT） and heart rate variability（HRV）in acute myocardial infarction（AMI）patients.Methods Totally one hundred and fifty patients with AMI were divided into timmediate PCI group,delayed PCI group and drug treatment group.Two to there weeks after AMI,24 h ambulatory electrocardiograph（holter） were used to detect the HRT parameter turbulence onset（TO）,turbulence slope（TS） and HRV index standard deviation of normal to normal Intervals（SDNN）,standard deviation of average NN intervals in all 5 min segments of the entire recording（SDANN）.Results Compared with delayed PCI group and drug treatment group,TO in immediate PCI group was significantly lower,TS,SDNN and SDANN was significantly higher（all P0.05）.Compared with drug treatment group,TO in delayed PCI group was lower,TS,SDNN and SDANN was higher（all P0.05）.Conclusions The treatment of immediate PCI and delayed PCI can significantly improve the myocardial ischemia of AMI and is favor to prevent malignant arrhythmia and sudden cardiac death;immediate PCI has better effects.