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为了解急性心肌梗死（AMI）后心率变异（HRV）的演变情况以及其与心脏组织结构改变之间的关系。采用闭胸式微珠法建立14条犬AMI模型。追踪存活7条犬心肌梗死（MI）后1周、2周HRV动态变化，并与AMI前14条健康犬相对照。处死犬后列检阻塞血管部位并称重坏死心肌。结果：MI后1周HRV时域、频域所有指标较健康犬MI前明显减低（P均＜0．05），MI后2周部分指标（SDNNin，rMSSD，PNN50，ULF，VLF）较1周前有所恢复，但无统计学意义（P＞0．05）。MI1周时HRV各指标与MI部位无关，而与MI范围相关，尤以SDANN，ULF显著（r分别为0．87，0．90，P均＜0．05）。至2周时，HRV则转变为与MI范围无关，而与MI部位有关，以PNNS50有统计学意义（r为0．88，P＜0．05）。结论：MI急性期HRV变化与MI范围的关系提示急性缺血及缺血程度可能与MI后HRV的下降有关。而HRV的远期恢复则与再灌注改善以及MI周围组织水肿、缺氧、代谢的改善有关。
To understand the evolution of heart rate variability (HRV) after acute myocardial infarction (AMI) and its relationship to changes in cardiac tissue structure. Fourteen Canine AMI models were established using closed-chest microbeads. The dynamic changes of HRV in 1 week and 2 weeks after myocardial infarction (MI) of 7 dogs were observed and compared with those of the 14 healthy dogs before AMI. After the dogs were killed, the blood vessels were obstructed and the necrotic myocardium was weighed. Results: After 1 week of MI, all the indexes of HRV in both time and frequency domains were significantly lower than those in healthy dogs (P <0.05), and some indexes (SDNNin, rMSSD, PNN50, ULF, VLF) Before recovery, but not statistically significant (P> 0.05). The indexes of HRV in MI1were not related to MI site, but correlated with MI range, especially SDANN and ULF (r = 0.87, 0.90, P <0.05 respectively). By 2 weeks, HRV was transformed to have nothing to do with the MI range but to the MI site, with PNNS50 being statistically significant (r = 0.88, P <0.05). Conclusion: The relationship between the changes of MI and the range of MI in acute MI suggest that acute ischemia and ischemia may be related to the decrease of HRV after MI. However, the long-term recovery of HRV is related to the improvement of reperfusion and the tissue edema, hypoxia and metabolism in MI.