摘要
目的探索一个新的非线性检测指标在冠状动脉支架植入术(PCI)评定预后中的价值。方法选取2009年11月至2010年3月哈尔滨医科大学第四附属医院住院的冠心病患者且行经皮冠状动脉介入治疗的PCI者18例,均给予常规检查,分别在行PCI术的前1夜、术后第3天、术后3个月的固定时间进行心电数据采集,剔除分析的心搏数RR间期小于90%者,最终15例符合实验要求。RR间期数据是由仰卧的受试者在稳定状态下,连续监测30 min的12导心电图所获得的,由试验者仔细检查后盲性移交给专业人员,进行数据过滤、由50步混沌强度公式分析计算后输出。运用单因素重复测量的方差分析进行统计分析。结果 (1)50步混沌强度(50SCM)在PCI术前与术后3 d之间相比无明显变化,无统计学意义(F=2.57,P>0.05),而PCI术后3个月的50SCM较术前有明显差异,有统计学意义(F=12.50,P<0.001)。结论 PCI术后3 d的50SCM与术前比较无统计学意义,提示此时除冠脉狭窄所致冠脉缺血缓解外,冠脉通过内分泌因子分泌异常而反馈于自主神经导致的心脏电活动可能仍未恢复;术后3个月50SCM与术前比较明显升高,提示该指标对预测预后可能有意义。
Objective To explore a new non-linear detection of changes in indicators before and after percutaneous coronary intervention（PCI） and their clinical significance. Methods The 18 inpatients had coronary heart disease with the eornonary stent implantation of the PCI were randomly selected from November 2009 to March 2010 in the departments of the fourth affiliated hospital of Harbin medical university, after given routine examination. The time was fixed in the night before PCI, after the third day, after a three-month for data acquisition, analysis of the number of cardiac RR interval （utilization） is less than 90＇% were removed, even- tually a total of 15 cases were selected. In a stable state ,experimenter give the supine subjects for 30 minutes of 12-lead ECG monitoring to obtain RR interval data, and after careful examination blindly transfer data to professionals who filter data, analysis by formula of 50-step ehaometry and output. Finally, the date were analy- sis with statistical methods. Result （ 1 ） The 50-step chaometry （50SCM） changes after three days, but no sta- tistical significance（ F = 2.57, P 〉 0.05 ）. （2）The chaotic strength were significantly amendment after three monthes （ F = 12.50, P 〈 0. 001 ）. Conclusion Coronary stenting with three days of chaotic strength values showed no significant change in preoperative, suggesting that at this time due to coronary ischemia than relieve coronary stenosis, coronary blood through abnormal secretion of endocrine factors caused by feedback on the autonomic cardiac electrical activity Chaos intensity changes has not been restored; after three months of 50SCM significantly increased compared with preoperative and follow-up no major adverse cardiovascular e- vents, suggesting that the prognosis may be meaningful indicators.
出处
《血栓与止血学》
2012年第3期116-119,共4页
Chinese Journal of Thrombosis and Hemostasis
基金
黑龙江省科技攻关项目(GB06C40301)
