【摘要】 目的探讨心率变异性(HRV)及平板运动试验(TET)评估心肌梗死患者心功能及预后的价值。方法心肌梗死患者60例,梗死后1~3周行24 h动态心电图检查,分析HRV指标,根据全部窦性心率间期的标准差(SDNN)评判患者危险度;梗死后3~6周行TET,并进行危险分层。结果运动试验阳性,运动量≤4 Met,心功能Ⅲ级9例;运动试验可疑阳性,运动量≤5 Met,心功能Ⅱ~Ⅲ级14例;运动试验阴性,运动量≥6 Met,心功能Ⅱ级以下37例。按SDNN标准属高危组10例,中危组22例,低危组28例。随访1年,高、中危组发生恶性心律失常6例,再发心肌梗死2例,死亡2例。低危组无以上心脏事件发生。结论 HRV联合TET对心肌梗死患者进行预后及心功能的评估有重要临床价值。更多还原

【Abstract】 Objective To investigate the clinical value of heart rate variability( HRV) and treadmill exercise test( TET) in the assessment of heart function and prognosis of patients with myocadial infarction( MI). Methods Sixty patients with myocardial infarction received 24-hours dynamic electrocardiogram 1- 3 weeks after the onset of the disease. HRV index was analyzed,and the risks were assessed according to standard diviation of NN intervals( SDNN). TET was performed 3- 6 weeks after the onset of the disease,and the risk stratification in patients was conducted. Results The result of TET showed 9 cases positive,with the exercise consumption no more than 4 Met and heart function of grade Ⅲ,14 cases suspected positive,with the exercise consumption no more than 5 Met and heart functions of grade Ⅱ- Ⅲ,and 37 cases negative,with the exercise consumption no less than 6 Met and heart function lower than grade Ⅱ. According to the SDNN standard,10 cases,22 cases and 28 cases were stratificated into high-risk group,medium-risk group and low-risk group respectively. After the 1-year follow-up,there were 6 cases of malignant ventricular arrhythmia,2 cases died for recurrent MI and 2 cases of death in the high- and medium-risk groups. No cardiac events mentioned above occurred in the low-risk group. Conclusion The combination of HRV and TET is valuable in evaluating the prognosis and heart function of patients with MI.更多还原