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目的 评价心率变异性 (HRV)在急性心肌梗塞 (AMI)患者中的变化及其预后意义。方法 应用动态心电图对 87例AMI患者和 2 5例年龄相当的正常人及AMI患者死亡组和生存组 2 4hHRV时域和频域指标进行对比分析。时域指标为 :正常R -R间期标准差 (SDNN) ,5min平均心率标准差 (SDANN) ,5minR -R间期标准差的平均数 (SDNNIDX) ,相邻R -R间期之差的均方根值 (RMSSD) ,差值 >5 0ms的百分比 (PNN50 ) ;频域指标为 :总频谱 (TF) ,低频 (LF) ,高频 (HF) ,心率谱密度为ms2 /Hz。结果 AMI组与正常组HRV时域和频域对比分析 ,所有指标均显著下降 ,时域中SDNN、SDANN、SDNNIDX和频域中HF下降尤为显著 ,AMI患者死亡组与生存组比较 ,各项指标进一步下降 (P <0 .0 5～ 0 .0 0 1)。结论 AMI患者植物神经活性减低 ,尤以副交感神经活性减低明显 ,且死亡者减低更显著。HRV可做为AMI患者独立的预后指标。
Objective To evaluate the changes and prognostic significance of heart rate variability (HRV) in patients with acute myocardial infarction (AMI). Methods 24 hHRV time-domain and frequency-domain indexes of 87 AMI patients and 25 normal controls and AMI patients were compared. The time domain indices are: normal R-R standard deviation (SDNN), 5-minute mean standard deviation (SDANN), average standard deviation of 5-minute R-R interval Root mean square (RMSSD), percentage difference> 5 ms (PNN50); frequency domain indicators: total spectrum (TF), low frequency (LF), high frequency (HF), heart rate spectral density ms2 / Hz. Results Compared with normal group, all the indexes of HRV in AMI group and normal group were significantly decreased, especially in SDNN, SDANN, SDNNIDX and HF in AMI group. Compared with survival group, Further decline (P <0. 05 ~ 0. 0 0 1). Conclusion The autonomic activity of patients with AMI is decreased, especially the parasympathetic activity is significantly reduced, and the death is more significantly reduced. HRV can be used as an independent prognostic indicator of AMI patients.