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目的比较延迟介入治疗和药物保守治疗对急性心肌梗死心率变异性的影响。方法选择34例急性心肌梗死患者分为两组:PCI组18例,住院1周左右行冠状动脉造影检并成功对梗死相关动脉行经皮冠脉介入治疗,残余狭窄<30%;非PCI组16例内科药物保守治疗,分别于入院后2d、随访2周、随访1个月时记录24h动态心电图,采用频域指标的HF(高频功率)及时域指标的SDNN(全部正常窦性心博间期的标准差),进行心率变异性的评价。结果PCI术后1周(即随访2周)与同期常规药物治疗相比,HRV有下降趋势,但尚无统计学意义。1个月与同期常规药物治疗相比,HRV又有升高的趋势,但无统计学意义。结论PCI术较药物治疗能更有效地改善心肌缺血,降低交患神经活性增加速起神经活性有关。
Objective To compare the effects of delayed interventional therapy and conservative treatment on heart rate variability in patients with acute myocardial infarction. Methods Thirty-four patients with acute myocardial infarction were divided into two groups: PCI group (n = 18), hospitalization for about 1 week underwent coronary angiography and successful infarction-related artery percutaneous coronary intervention with residual stenosis <30%; non-PCI group Cases of conservative treatment of medical drugs, respectively, 2d after admission, follow-up of 2 weeks, 1-month follow-up recorded 24h Holter, the use of frequency domain indicators of HF (high frequency power) and time domain index SDNN (all normal sinus heartbeat interval Standard deviation), the evaluation of heart rate variability. Results One week after PCI (ie 2 weeks follow-up) HRV showed a decreasing trend compared with that of the same period of conventional medicine, but there was no statistical significance. One month Compared with the same period of conventional drug treatment, HRV has an increasing trend, but not statistically significant. Conclusion PCI is more effective than drug treatment to improve myocardial ischemia and reduce the sympathetic nerve activity increased rapidly from the nerve activity.