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目的通过对急性心肌梗死(AMI)患者心率震荡(HRT)的检测及结果分析,评价HRT对AMI室性心律失常患者预后的临床意义。方法随机选择AMI室性心律失常患者96例和健康体检者90例分别作为病例组和对照组,进行24hHolter检查,并根据室性早搏(VPC)发生频率,定量测量HRT的震荡起始(TO)和震荡斜率(TS)。结果组间HRT参数的比较:震荡起始(TO)均值和异常率,AMI组较对照组显著增高,震荡斜率(TS)均值AMI组较对照组明显降低,异常率AMI组较对照组增高,差异有统计学意义(P<0.05);AMI组中27例TO、TS均异常,占12.22%,对照组中7例TO、TS均异常,占7.78%,两组间比较有统计学意义(P<0.05);AMI组中VPC发生频度与HRT参数的比较:17例频发VPC的AMI患者中,TO均值较偶发VPC者增高,TS均值较偶发VPC者明显降低,频发VPC者中11例TO、TS均异常,占64.71%,但无统计学意义(P>0.05)。结论AMI组患者HRT较对照组明显变钝,TO升高和TS降低,AMI组HRT异常者发生率明显高于对照组,并且与AMI患者VPC发生的频率呈正相关。
Objective To evaluate the clinical significance of HRT in the prognosis of patients with AMI with ventricular arrhythmias by detecting heart rate turbulence (HRT) in patients with acute myocardial infarction (AMI) and analyzing the results. Methods Ninety-six patients with AMI and 90 healthy subjects were randomly selected as the case group and the control group for 24-hour Holter examination. The onset of heart rate (HRT) onset was quantified according to the frequency of ventricular premature beat (VPC) And the oscillation slope (TS). RESULTS: Comparison of HRT parameters between the two groups showed that mean and abnormal rate of start of shock (TO), AMI group was significantly higher than that of the control group, AMI group was significantly lower than the control group, meanwhile AMI group was higher than the control group, The difference was statistically significant (P <0.05). There were 27 cases of TO and TS abnormalities in AMI group, accounting for 12.22%, while 7 cases of TO and TS in control group were abnormal, accounting for 7.78%. There was significant difference between the two groups P <0.05). The comparison of VPC frequency and HRT parameters in AMI group: In 17 AMI patients with frequent VPC, the TO mean was higher than that of sporadic VPC, and the TS mean was significantly lower than that of sporadic VPC 11 cases of TO, TS were abnormal, accounting for 64.71%, but no statistically significant (P> 0.05). Conclusion The HRT of AMI patients was significantly blunted, TO increased and TS decreased. The incidence of abnormal HRT in AMI patients was significantly higher than that in control patients and positively correlated with the frequency of VPC in AMI patients.