经皮冠状动脉介入术对冠心病患者心率变异性的影响

目的: 观察冠心病患者经皮冠状动脉介入术(PCI)后心率变异性(HRV)变化,评估PCI对冠心病预后的影响。方法: 选择经冠状动脉造影证实适合PCI的患者32例,其中心绞痛组20例,心肌梗死组12例,于PCI术前、术后3个月、6个月分别测HRV时域指标和频域指标。结果: PCI术后1个月HRV中24 h正常窦性R-R间期标准差、24 h每5 min窦性R-R间期均值标准差和高频均较术前改善(P<0.05),而术后6个月HRV除正常连续窦性R-R间期差值均方根(P>0.05)外,其余指标均进一步改善(P<0.01)。结论: PCI可以改善冠心病患者的心率变异性,可能与PCI改善了患者心肌缺血及纠正神经体液因子对窦房结功能、心室肌功能的调控失衡有关。

Influence of percutaneous coronary intervention on heart rate variability in patients with coronary disease

Objective:To observe the change of heart rate variability(HRV) in patients with coronary artery disease(CAD) before and after percutaneous coronary intervention(PCI) and to evaluate the prognosis of CAD patients receiving PCI.Methods:Thirty-two PCI patients confirmed by coronary arteriography and suitable to PCI were divided into angina pectoris group(20 cases) and myocardial infarction group(12 cases).The time-domain(SDNN,SDANN,rMSSD,PNN50) and frequency-domain(LF,HF) of HRV were analyzed before PCI and one month,six months after PCI.Results:There was a significant improvement of SDNN,SDANN and HF(P<0.01) one month after PCI,and more improvement was observed in other indices(P<0.01) except rMSSD(P>0.05)six months after PCI.Conclusions:HRV in patients with CAD can be improved significantly after PCI,and it may be related to the improvement of myocardial circulation,and the correction of the dysfunction of sinus node and myocardium due to the unbalance of neuro-humoral factors.