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目的探讨窦性心率震荡(heart rate turbulence,HRT)在急性冠脉综合征(acute coronary syndrome,ACS)患者诊疗中的临床价值。方法选择2005年1月—2008年2月在我院心内科住院并确诊的ACS患者160例,其中不稳定型心绞痛57例,急性心肌梗死103例,健康对照组57例,所有入选患者均接受动态心电图检查,测量HRT的参数TO、TS、心率变异的参数SDNN及左室射血分数(left ventricular ejection fraction,LVEF)。结果ACS患者HRT较正常健康人群显著减弱,急性心肌梗死患者HRT减弱更加明显,ACS患者HRT减弱程度与LVEF呈显著负相关。结论HRT可作为检测ACS患者压力感受器敏感性减退和自主神经功能受损,尤其是迷走神经反射功能受损以及判断ACS患者心功能状态的有价值参考指标。
Objective To investigate the clinical value of heart rate turbulence (HRT) in the diagnosis and treatment of acute coronary syndrome (ACS). Methods From January 2005 to February 2008 in our hospital cardiology department of hospitalized and diagnosed ACS patients 160 cases, including 57 cases of unstable angina pectoris, acute myocardial infarction in 103 cases, 57 cases of healthy control group, all patients were enrolled Holter, HRT parameters TO, TS, parameters of heart rate variability SDNN and left ventricular ejection fraction (LVEF). Results The HRT of ACS patients was significantly weaker than that of normal healthy people. The HRT weakened more obviously in patients with acute myocardial infarction. The degree of HRT weakened in ACS patients was negatively correlated with LVEF. Conclusions HRT can be used as a valuable reference for detecting baroreflex sensitivity and impaired autonomic function in ACS patients, especially impaired vagal reflex function and for judging cardiac function in patients with ACS.