【摘要】 目的探讨急性冠状动脉综合征中急性心肌梗死与不稳定型心绞痛心率变异性,明确自主神经变化规律,为进一步观察治疗及指导预后提供参考价值和新的治疗策略。方法将急性冠状动脉综合征患者根据临床分型分为急性心肌梗死组(A组,32例)和不稳定型心绞痛组(B组,47例),24 h动态心电图检查分析其心率变异性。结果 A组心电图R-R间期的标准差(standard deviations of normal-to-normal R-R intervals,SDNN)、心电图R-R间期均值的标准差(standard deviation of the average normal-to-normal intervals,SDANN)及心电图相邻R-R间期差值的均方根(root mean square of successive differece,RMSSD)均明显小于B组,差异有统计学意义(P<0.05),2组相差在50 ms的R-R间期的数量占所有R-R间期数量的比例(proportion of number of pairs of adjacent normal-to-normal intervals by more than 50 ms,pNN50)差异无统计学意义(P>0.05)。结论急性冠状动脉综合征中急性心肌梗死组较不稳定型心绞痛组自主神经功能受损更严重,应根据心率变异性变化情况积极改善患者自主神经功能状态,降低冠心病并发症发生率,改善冠心病患者预后。更多还原

【Abstract】 Objective To investigate the heart rate variability of acute myocardial infarction and unstable angina in acute coronary syndrome, and to clarify the autonomic nerve change rule, so as to provide reference value and new treatment strategy for further observation and treatment and guidance of prognosis. Methods Patients with acute coronary syndrome were divided into acute myocardial infarction group(group A, 32 cases) and unstable angina pectoris group(group B, 47 cases) according to clinical classification. Results Standard deviations of normal-to-normal R-R intervals(SDNN), standard deviation of the average normal-to-normal intervals(SDANN) and root mean square of successive differece(RMSSD) of group A were significantly lower than that of group B, with statistically significant difference(P<0.05), while proportion of number of pairs of adjacent normal-to-normal intervals by more than 50 ms(pNN50) of 2 groups showed no statistically significant difference(P>0.05). Conclusion In acute coronary syndrome, the autonomic nervous function of the acute myocardial infarction group is more seriously impaired than that of the unstable angina group. The autonomic nervous function of the patients should be actively improved according to the changes in heart rate variability, so as to reduce the incidence of coronary heart disease complications and improve the prognosis of patients with coronary heart disease.更多还原