急诊与限期PCI对急性心肌梗死后心率变异性及心功能的影响与比较

目的 比较急诊与限期经皮冠脉介入（PCI）术对急性心肌梗死(AMI)后心率变异性（HRV）及心功能的影响。方法 共收集随访资料完整的120例AMI患者，包括行急诊PCI治疗42例和行限期PCI治疗38例；而未行任何冠脉再灌注治疗（包括静脉溶栓或PCI术）40例为对照组。分析比较3组患者AMI后1个月、6个月随访时动态心电图检查中的HRV资料及心脏超声检查测定的左室射血分数（LVEF）。结果 AMI后1、6个月时，与未行任何冠脉再灌注治疗的对照组患者相比较，PCI治疗组患者HRV时域指标SDNN、SDANN、rMSSD、PNN50及LVEF均显著提高，而且急诊PCI治疗组患者较限期PCI治疗组患者进一步提高，差异性均有统计学意义（P<0.05，P<0.01）。结论 急诊与限期PCI都可以改善提高AMI患者的HRV及心功能,尤以急诊PCI更为显著。

Comparison of the effects of heart rate variability and heart function on emergency and elective percutaneous coronary intervention in patients with acute myocardial infarction

AIM To investigate the effect on heart rate variability (HRV) and heart function of emergency and selective PCI in patients with acute myocardial infarction (AMI). METHODS One hundred and twenty patients with AMI were divided into emergency PCI group (n=42) and elective PCI group (n=38) and control group without receiving any coronary artery reperfusion (n=40). HRV and left ventricular ejection fraction (LVEF), respectively, measured with dynamic electrocardiogram and echocardiography, were applied to observe all cases at 1 and 6 months after AMI. RESULTS There are significant differences between receiving PCI group and control group for HRV and LVEF at 1 and 6 months after AMI. Compared with control group, HRV time domain indexes (SDNN, SDANN, rMSSD, PNN50) and LVEF improve in PCI group. Emergency PCI group is more significant than selective PCI group (P<0.05, P<0.01). CONCLUSION SBoth emergency and selective PCI therapy can improve HRV and heart function in patients with AMI. Emergency PCI is more significant.