早期静脉溶栓对急性心肌梗死患者窦性心率震荡的影响

目的探讨静脉溶栓治疗急性心肌梗死（AMI）后对窦性心率震荡（HRT）的影响。方法将108例急性心肌梗死患者分为早期组、中期组和保守治疗组，早期组及中期组给予静脉溶栓、保守治疗组给予药物治疗。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：24h时平均R。R间距的标准差（SDNN），每5分钟时间段R—R间距平均值的标准差（SDANN）。结果早期组TO明显低于，TS、SDNN、SDANN明显高于中期组及保守治疗组（P均〈0．01）。结论早期静脉溶栓可有效地改善AMI心肌缺血，有利于防止恶性心律失常和心性猝死的发生。溶栓时间越早效果越好。

Effects of early intravenous thrombolytic therapy on heart rate turbulence in patients with acute myocardial infarction

Objective To investigate the sinus heart rate turbulence （HRT） in the treatment of acute myocardial infarction （AMI） after intravenous thrombolysis. Methods One hundred and eight a-cute myocardial infarction patients were divided into early group, the mediccm-term group and conserva-tive treatment group. The early group and the medium-term group were given intravenous thrombolysis, conservative treatment group received medication. HRT parameters were analyzed by Hoher in all of group 2 -3 weeks after AMI： turbulence onset （TO） and turbulence slope （TS）, and at the same time get HRV indicators： 24 h average of R. R spacing standard deviation （ SDNN）, RR interval of each 5 rain period average standard deviation （SDANN）. Results To in the early group was significantly lower than the TS, SDNN SDANN were significantly higher than those in the mid-group and the conserva- tive treatment group （ P 〈 0.01 ）. Conclusions Early intravenous thrombolysis can effectively improve AMI myocardial ischemia, help prevent malignant cardiac rhythm disorders and sudden cardiac death oc-curred; the sooner the thrombolytic is, the better the effect is