62例不稳定型心绞痛患者窦性心率震荡临床分析.pdf

62 例不稳定型心绞痛患者窦性心率震荡临床分析 论文代写网： 作者：王锋 刘杰 闫兴国 吴秀明 罗群 吴玉超 【摘要】目的观察不稳定型心绞痛（unstable angina pectoris， UAP）患 者窦性心率震荡（heart rate turbulence， HRT）现象的特征并探讨其临床意 义。方法 选择62 例UAP 患者和在性别、年龄上相匹配的60 例健康者分别作为 UAP 组和对照组，UAP 组内分为高危组(n=20)、中危组(n=22)、低危组(n=20)； 均接受 24 h Holter 检查，定量测量 HRT 包括震荡初始（TO）和震荡斜率（TS） 2 个指标，并进行统计学处理。结果 UAP 组TO 明显高于对照组〔（0.16± 0.33）%vs.(－1.59±0.70)%，P＜0.01〕，TS 明显低于对照组〔（2.15±0.04） ms/RRI vs. （3.11±0.09） ms/RRI，P＜0.05〕；UAP 组中低危组TO 明显低于 高危组〔（-0.07±0.34）%vs. (0.18±0.15)%，P＜0.01〕，低危组TS 明显高 于高危组〔（2.16±0.22） ms/RRI vs.(2.03±0.19) ms/RRI，P＜0.05〕；中 危组与高危组及低危组与中危组比较均无明显差异。结论 UAP 患者中HRT 现象 明显减弱，在高危组和低危组之间差异有显著性，可以作为预测UAP 预后和高 危患者的新指标。 【关键词】窦性心率震荡；心绞痛，不稳定型；动态心电图；危险性评估；自 主神经功能；预后 Abstract: Objective To explore the features of heart rate turbulence (HRT) in patients with unstable angina pectoris (UAP) and its clinical significance. Methods Sixty-two patients with UAP and sixty healthy controls were enrolled in the study. The UAP patient group was subpided into high- middle- and low-risk groups (n=20， 22 and 20 repectively). The HRT， including its turbulence onset (TO) and turbulence slope (TS) were determined by using digitized Holter recordings. Results Compared to that in control group， TO was significantly higher in UAP group ［(0.16±0. 33)% vs. (－1.59±0.70)%， P＜0.01］； TS was significantly lower in UAP group ［(2.15±0.04) ms/RRI vs. (3.11±0.09) ms/RRI， P＜0.05］. Compared to that in high- risk group， TO was lower in the low-risk group ［(－0.07±0.34) % vs. (0.18±0.15) %， P＜0.01］ and TS was higher in the low-risk group ［(2.16±0.22 )ms/RRI vs. (2.03±0.19) ms/RRI， P＜0.05］. Conclusions HRT is significantly blunted in UAP and shows significant differences between that in low-risk group and high-risk groups. Hence， HRT may become a new predictor for the prognosis and the high risk in patients with UAP. Key words: heart rate turbulence; unstable angina pectoris; dynamic electrocardiography; risk assessment; auto