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目的回顾性分析窦性心律震荡现象(HeartRateTurbulence,简称HRT)对急性心肌梗死患者预后的影响。方法选择1997年2月～2004年12月的急性心肌梗死患者405例,其中急性心肌梗死后2～3周内有室性早搏(室早)并且在24h动态心电图(Holter)或监护导联上能记录到室早前至少有3个正常的窦性心搏,室早后有连续20个以上窦性心搏的患者355例。将患者分为死亡组和存活组,记录各组患者可能影响预后的相关指标,包括年龄、性别、吸烟、高血压、血脂异常、糖尿病、家族史、尿酸升高、急性心肌梗死部位、采取的治疗措施、左室射血分数(均采用面积长轴法)、心肌梗死二级预防用药(ACEI、Aspirin、Statin、β-Blockor等)以及HRT分类。结果355例患者平均随访(22.0±12.3)个月,死亡58例。Logistic多元回归分析显示急性心肌梗死死亡与HRT分类、低LVEF(≤55%)及高龄(≥65岁)显著相关(P<0.001)。结论窦性心律震荡现象是预测急性心肌梗死死亡率的良好指标。
Objective To retrospectively analyze the effect of sinus rhythm turbulence (HRT) on the prognosis of patients with acute myocardial infarction. Methods A total of 405 acute myocardial infarction patients from February 1997 to December 2004 were enrolled in this study. Ventricular premature beats (ventricular premature beats) were observed within 2 to 3 weeks after acute myocardial infarction. Can be recorded earlier in the room at least 3 normal sinus beats, ventricular early and more than 20 consecutive patients with more than 355 cases of sinus beats. The patients were divided into the death group and the survival group. The relevant indicators of each group, such as age, sex, smoking, hypertension, dyslipidemia, diabetes, family history, elevated uric acid, acute myocardial infarction, Treatment measures, left ventricular ejection fraction (both long axis method), secondary prevention of myocardial infarction (ACEI, Aspirin, Statin, β-Blockor, etc.) and HRT classification. Results 355 patients were followed up for an average of (22.0 ± 12.3) months, 58 patients died. Logistic multivariate regression analysis showed that the mortality of acute myocardial infarction was significantly associated with HRT classification, low LVEF (≤55%) and advanced age (≥65 years) (P <0.001). Conclusions Sinus arrhythmia is a good predictor of mortality in acute myocardial infarction.