[1]张小岗,何 雅△.不同冠状病变支数及年龄段急性心肌梗死患者动态心电图分析*[J].陕西医学杂志,2020,49(7):821-823854.[doi:DOI:10.3969/j.issn.10007377.2020.07.014]
　ZHANG Xiaogang,HE Ya..Dynamic electrocardiogram analysis of AMI patients with different coronary lesions and age groups[J].,2020,49(7):821-823854.[doi:DOI:10.3969/j.issn.10007377.2020.07.014]
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不同冠状病变支数及年龄段急性心肌梗死患者动态心电图分析*
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
49
期数:
2020年7期
页码:
821-823854
栏目:
临床研究
出版日期:
2020-07-05

文章信息/Info

Title:
Dynamic electrocardiogram analysis of AMI patients with different coronary lesions and age groups
作者:
张小岗; 何 雅△
西安医学院附属宝鸡医院心电科(宝鸡 721006)
Author(s):
ZHANG Xiaogang; HE Ya.
Department of Electrocardiology,Affiliated Baoji Hospital of Xi'an Medical University(Baoji 721006)
关键词:
心肌梗死;  动态心电图;  冠状病变;  年龄;  诊断;  危险程度
Keywords:
Myocardial infarction;  Dynamic electrocardiogram;  Coronary lesions;  Age;  Diagnosis;  Risk degree
分类号:
R543.1
DOI:
DOI:10.3969/j.issn.10007377.2020.07.014
文献标志码:
A
摘要:
目的:比较不同冠状病变及年龄段急性心肌梗死(AMI)患者动态心电图的差异,为AMI的诊断、危险程度及治疗提供参考依据。方法:选择120例AMI患者的临床资料,按冠状动脉病变支数分为单支病变组(45例)、二支病变组(37例)及三支病变组(38例),按年龄段分为<60岁组(22例)、60～75岁组(44例)、≥75岁组(54例),均接受24 h动态心电图检查,分析组间的心率变异性(HRV)时域指标及频域指标,包括24 h连续NN间期的标准差(SDNN)、24 h连续5 min正常NN间期标准差均值(SDANN)、相邻RR间期差值大于50 ms百分比(PNN50)、正常连续窦性RR间期差值均方根(RMSSD)、频域指标极低频谱功率(VLF)、高频谱功率(HF)、低频谱功率(LF); 窦性心率震荡(HRT)指标,包括震荡斜率(Ts)和震荡初始(T0); 以及V1、V3、V5导联的最大微伏级T波电交替(MTWAmax)。结果:单支、两支、三支病变患者的SDNN、SDANN、Ts比较差异具有统计学意义(P<0.05),RMSSD、PNN50、VLF、LF、HF、T0、V1-MTWAmax、V3-MTWAmax、V4-MTWAmax比较差异无统计学意义(P>0.05); <60岁、60～75岁、≥75岁患者的ADNN、SDANN、Ts、HF及V1-MTWAmax比较差异有统计学意义(P<0.05),RMSSD、PNN50、VLF、LF、T0、V3-MTWAmax、V5-MTWAmax比较差异无统计学意义(P>0.05)。结论:AMI患者的动态心电图HRV时域和HRT现象的改变与其年龄和冠状病变支数有关,可为AMI的诊断、危险程度预测提供重要的信息。
Abstract:
Objective:To compare the difference of dynamic electrocardiograms in patients with acute myocardial infarction(AMI)of different coronary lesions and age groups,so as to provide reference for the diagnosis,risk degree and treatment of AMI. Methods:According to the number of coronary lesions,120 patients with AMI were divided into single-branch lesion group(45 cases),two-branch lesions group(37 cases)and three-branch lesions group(38 cases). According to the age group,the patients were divided into < 60 years old group(22 cases),60-75 years old group(44 cases)and ≥ 75 years old group(54 cases). All patients received 24-hour dynamic electrocardiogram(ECG). The time domain and frequency domain indexes of HRV,the sinus heart rate concussion(HRT)indexes and V1,V3,V5 lead of the maximum microvolt T wave alternating(MTWAmax)among groups were analyzed. The time domain and frequency domain indexes of HRV included the standard deviation of 24-hour continuous NN interval(SDNN),the mean standard deviation of 24-hour continuous 5-minute normal NN interval(SDANN),the difference of adjacent RR interval greater than 50 ms percentage(PNN50),the difference of normal continuous sinus RR interval(RMSSD),the very low frequency spectrum power(VLF),high frequency spectrum power(HF)and low frequency spectrum power(LF). The sinus heart rate concussion(HRT)indexes included concussion slope(Ts)and concussion initial(T0). Results:Comparison of SDNN,SDANN and Ts in patients with single-branch,two-branch and three-branch lesions were statistically significant(P<0.05),while comparison of RMSSD,PNN50,VLF,LF,HF,T0,V1-MTWAmax,V3-MTWAmax,V4-MTWAmax were not statistically significant(P>0.05). ADNN,SDANN,Ts,HF and V1-MTWAmax in patients with different age groups were statistically significant(P<0.05),while comparison of RMSSD,PNN50,VLF,LF,T0,V3-MTWAmax and V5-MTWAmax were not statistically significant(P>0.05). Conclusion:The changes of dynamic electrocardiogram HRV time domain and HRT in patients with AMI are related to their age and number of coronal lesions,which can provide important information for the diagnosis and risk degree prediction of AMI.

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备注/Memo

备注/Memo:
*陕西省自然科学基金资助项目(SX461322-51C)
更新日期/Last Update: 2020-07-28