113例急性心肌梗死心率变异性与恶性心律失常相关性的研究

目的:探讨急性心肌梗死(AMI)患者的心率变异性(HRV)情况与恶性室性心律失常发生率及猝死率的相关性,预测AMI患者的病情及预后。方法:对113例已确诊AMI患者进行24 h动态心电图检查,对HRV进行时域分析(主要参数为全部正常窦性心动周期的标准差-SDNN),监测恶性室性心律失常的发生率,然后随访患者1年。结果:SDNN<50 ms,预测高危险水平的患者31例;SDNN介于50 ms～100 ms,预测中危险水平患者36例;SDNN介于100 ms～150 ms,预测低危险水平患者46例。高危险水平患者组发生恶性室性心律失常19例,猝死6例;中危险水平患者组发生恶性室性心律失常9例,猝死1例;低危险水平患者组发生恶性室性心律失常5例,无猝死。3组患者恶性室性心律失常发生率比较,P<0.05,心脏猝死率比较,P<0.01。结论:HRV减小程度与恶性室性心律失常及猝死发生率有正相关性,HRV在预测AMI患者的危险性及预后起着重要作用。

To study the relationship between heart rate variability and malignant arrhythmia in 113 cases of acute myocardial infarction

Objective:To study the relationship between heart rate variability(HRV) and malignant ventricular arrhythmia and sudden death in acute myocardial infarction(AMI) patients and the pathogenetic condition and prognosis.Methods:To study time domain analysis of HRV(the main parameter: SDNN) and the incidence rate of malignant ventricular arrhythmia with Holter monitoring in 113 cases of AMI,and then follow up one year.Results:31 cases as high risk group(SDNN<50ms),36 cases moderate risk group(SDNN 50-100 ms) and 46 cases low risk group(SDNN 100-150 ms).The amount of malignant ventricular arrhythmia and sudden death were 19 cases and 6 cases in high risk group,9 cases and 1 cases in moderate risk group,5 cases and 0 cases in low risk group.The incidence rate of malignant ventricular arrhythmia and sudden death in 3 group was significant(P<0.05 and P<0.01).Conclusion:There were direct correlation between HRV and malignant ventricular arrhythmia and sudden death in AMI.HRV is important to estimate the risk and prognosis in AMI.