溶栓疗法对急性心肌梗塞心率变异的影响
曲秀芬,黄永麟,富路,纪树彦,杜巧婷,朴晶艳,宋丽云
摘要(Abstract)：
选用尿激酶、链激酶对35例急性心肌梗塞(AMI)病人进行溶栓治疗.设年龄、性别、病情相似并予以常规治疗的AMI35例作对照.于治疗前后进行心率变异(HRV)分析、Holter监测、心功能测定.分别对比溶栓血管再通组与非再通组及对照组治疗前后的HRV(时域指标:SDNN、rMSSD、PNN_(50);频域法指标:HF、LF、LF/HF)、心肌缺血(发生次数、程度)及心功能(LVEF、LVVD、A/E,MV流速、Wall Index)变化.结果:溶栓致血管再通20例,血管再通组的SDNN、rMSSD、PNN_(50)、HF较对照组及非再通组明显增大(P<0.05～0、01)、LF/HF比值减少(P<0.05),心功能较早而明显得到改善,心肌缺血次数减少(P<0.01).从而表明:溶栓致血管再通影响于左室重构,减小了左室扩张,改善了自主神经失衡状态,心肌缺血减少,心功能得到较快恢复,改善了AMI病人的近期预后.
关键词(KeyWords)： 溶栓疗法;急性心肌梗塞;心率变异
基金项目(Foundation):
作者(Author): 曲秀芬,黄永麟,富路,纪树彦,杜巧婷,朴晶艳,宋丽云
参考文献(References)：
- [1]Kleiger RE.Miller JP,Bigger JT,et al.Decreased heart rate variability and its assoiation with increased mortality after acute myocardiol infarction.Am J Cardiol,1987,59:256.
- [2]Zipes DP.Influence of myocardial ischemic and infarction autonomic innervation of heart.Circulation 1990,82:1095.
- [3]曲秀芬,纪树彦.黄永麟,等.冠心病心肌缺血发作时自主神经的变化.心脏起搏与心电生理杂志,1994,8:59.
- [4]Bigger JT,Fleiss JL,Steinman RC,et al.Frequency domain measures of heart period variability and mortality after acute myocardiol infarction.Circulation,1992,55:164.
- [5]Hull SS Jr,Evans AR,Vanoli F,et al.Heart rate variability and sudden death in conscious dogs befor and after acute myocardiol infarction.Circulation,1988,78[suppl Ⅱ]:11.
- [6]Antonio G,Hermesillo F,Miguel D,et al.Influence of infarct-related artery patency on the indexes of parasympathetic activity and prevalence of late potentials in survivors of acute myocardiol infarction.J Am Coll Cardiol,1993,22:695.
- [7]Bigger JT,Clerger RE,Fleiss JT,et al.Components of heart rate variability measured during healing of acute myocardiol infarction.Am J Cardiol,1988,61:208.
- [8]Farrell TG,Bashir Y,Cripps T et al.Risk stratification for arrythmia events in postinfarction patients based on heart rate variability,ambulantory electrocardiolgraphic variables and the signal-averaged elesteocardiogram.J Am Coll Cardiol,1991,18:687.