摘要
目的:探究24h动态心电图[心率变异性(HRV)、QT间期变异性(QTV)]联合中性粒细胞淋巴细胞比值(NLR)预测急性心肌梗死(AMI)后恶性心律失常的临床价值。方法:选择2014年8月至2018年8月我院心内科收治的AMI患者96例(AMI组)及同期本院体检正常志愿者60例(对照组)纳入研究,AMI组患者根据是否发生恶性心律失常分为恶性组(38例)与非恶性组(58例)。对所有研究者均进行24h动态心电图检查,监测并比较HRV、QTV指标及NLR值变化,并采用受试者工作特征曲线(ROC)分析HRV、QTV指标及NLR值预测恶性心律失常事件发生的价值。结果:AMI组SDNN、SDNN-index、SDANN-index、r MSSD、24h-QTV、Day-QTV、Night-QTV、NLR值均显著低于对照组,差异有统计学意义(P<0.05);恶性组除r MSSD外,SDNN、SDNN-index、SDANN-index、24h-QTV、Day-QTV、Night-QTV、NLR值均显著低于非恶性组,差异有统计学意义(P <0.05); ROC曲线分析提示,HRV、QTV指标联合NLR值预测AMI后恶性心律失常发生的价值更高,ROC曲线下面积最大(0.892)。结论:HRV、QTV指标联合NLR值可预测AMI后恶性心律失常事件的发生。
Objective: To investigate the clinical value of 24h dynamic electrocardiogram [heart rate variability (HRV), QT interval variability (QTV)] combined with the neutrophil lymphocyte ratio (NLR) in predicting malignant arrhythmia after acute myocardial infarction (AMI). Methods: 96 patients with AMI (AMI group) who were admitted to cardiology department in the hospital from August 2014 to August 2018 and 60 normal volunteers (control group) who underwent physical examination in the hospital during the same period were included in the study. Patients in AMI group were divided into the malignant group (38 cases) and the non-malignant group (58 cases) according to the occurrence of malignant arrhythmia. All subjects were given 24h dynamic electrocardiogram examination. Changes of HRV , QTV and NLR value were monitored and compared. The value of HRV, QTV indicators and NLR values in predicting the occurrence of malignant arrhythmia was analyzed by receiver operating characteristic (ROC) curve. Results: The values of SDNN, SDNN-index, SDANN-index, rMSSD, 24h-QTV, Day-QTV, Night-QTV and NLR in AMI group were significantly lower than those in the control group (P<0.05). Except rMSSD, the values of SDNN, SDNN-index, SDANN-index, 24h-QTV, Day-QTV, Night-QTV and NLR in the malignant group were significantly lower than those in the non-malignant group (P<0.05). ROC curve analysis indicated that the value of HRV and QTV indicators combined with NLR values in predicting the occurrence of malignant arrhythmia after AMI was greater, and the area under ROC curve was the largest (0.892). Conclusion: HRV and QTV indicators combined with NLR values can predict the occurrence of malignant arrhythmia after AMI.
作者
邹华丽
ZOU Huali(ECG Room of Chengdu 363 Hospital, Sichuan Chengdu 610041, China)
出处
《河北医学》
CAS
2019年第4期598-602,共5页
Hebei Medicine
基金
四川省科技厅科技支撑计划
(编号:2014SZ01679)
