摘要
目的:研究心率震荡(HRT)与心率变异性(HRV)对急性心肌梗死(AMI)心脏骤停患者急救预后评估的效能。方法:回顾性分析2018年3月-2019年3月广宁县人民医院急诊科接诊的可测得HRT值的60例AMI心脏骤停急救患者临床资料,对这60例患者的HRT值[震荡初始值(TO)与震荡斜率值(TS)]、HRV值[RR间期平均值标准差(SDANN)、窦性心搏RR间期的标准差(SDNN)]进行分析,并对患者的预后情况随访1年,以患者死亡为终点事件。根据患者预后将其分为存活组(n=49)与死亡组(n=11)。49例存活患者中,再发心肌梗死或心衰者18例,无再发心脏事件者31例,据此将49例患者分为再发组(n=18)与无再发组(n=31)。结果:存活组的TS、SDANN和SDNN值均高于死亡组,而TO值低于死亡组,差异均有统计学意义(P<0.05)。再发组TO值高于无再发组,而TS、SDANN和SDNN值均低于无再发组,差异均有统计学意义(P<0.05)。TO、TS、SDANN、SDNN值的AUC分别为0.937、0.954、0.905、0.725(P<0.01)。结论:HRT指标TS、TO值对于AMI心脏骤停患者预后的评估效能优于HRV指标SDANN和SDNN,TS值评估效能为四项指标中最优,SDNN最低。
Objective:To study the prognostic performance of heart rate turbulence(HRT)and heart rate variability(HRV)in patients with acute myocardial infarction(AMI)and cardiac arrest undergoing emergency treatments.Method:The clinical data of 60 emergency AMI patients with cardiac arrest and measurable HRT values who were admitted to the Emergency Department of Guangning People’s Hospital from March 2018 to March 2019 were retrospectively analyzed.HRT values[turbulence onset(TO)and turbulence slope(TS)]and HRV values[standard deviation of N-N intervals(SDANN),standard deviation of R-R intervals(SDNN)]of the 60 patients were analyzed.The patients were followed up for 1 year,with death as the end event.Then,they were divided into survival group(n=49)and death group(n=11)according to the prognosis.Among the 49 survival patients,there were 18 patients with recurrent myocardial infarction or heart failure,and 31 patients without recurrent cardiac event,who were included in recurrence group(n=18)and non-recurrence group(n=31),respectively.Result:TS,SDANN and SDNN values in survival group were higher than those in death group,and TO value in survival group was lower than that in death group,the differences were statistically significant(P<0.05).TO values in recurrence group was higher than that in non-recurrence group,while TS,SDANN and SDNN values in recurrence group were lower than those in non-recurrence group,the differences were statistically significant(P<0.05).The AUC values of TO,TS,SDANN and SDNN value were 0.937,0.954,0.905 and 0.725,respectively(P<0.01).Conclusion:The prognostic performance of TS and TO values is better than that of SDANN and SDNN in patients with AMI and cardiac arrest.Among the four indexes,the performance of TS value is the best and the performance of SDNN is the worst.
作者
梁文权
冯庆金
陈嘉铭
LIANG Wenquan;FENG Qingjin;CHEN Jiaming(Guangning People’s Hospital,Guangning 526300,China;不详)
出处
《中外医学研究》
2022年第4期4-7,共4页
CHINESE AND FOREIGN MEDICAL RESEARCH
基金
肇庆市科技计划项目(201904030760)。
关键词
急性心肌梗死
心脏骤停
心率震荡
心率变异性
预后评估价值
Acute myocardial infarction
Cardiac arrest
Heart rate turbulence
Heart rate variability
Prognostic value
