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[目的]探讨急性心肌梗死(AMI)患者早期心律震荡(HRT)与梗死面积及预后的关系。[方法]选择165例早期AMI患者进行24h动态心电图(Holter)检查,计算HRT的两个参数:震荡初始(TO)和震荡斜率(TS),并对TO、TS进行分析。所有患者根据是否发生心源性死亡分为死亡组和生存组。规定12导心电图中病理性Q波导联数≥4者为大面积梗死,≤3者为小面积梗死。组间比较采用χ2检验。[结果]死亡组TO≥0且TS≤2.5ms/RR间期的阳性率显著高于生存组(P﹤0.01)。大面积AMI组TO≥0且TS≤2.5ms/RR间期的阳性率显著高于小面积AMI组(P﹤0.01)。[结论]TO,TS值的变化与AMI患者早期的心源性死亡及梗死面积密切相关。HRT的减弱或消失可作为预测AMI患者早期发生恶性心脏事件的敏感指标之一。
[Objective] To investigate the relationship between early heart rate turbulence (HRT) and infarct size and prognosis in patients with acute myocardial infarction (AMI). [Methods] A total of 165 patients with early AMI were selected for Holter examination. Two parameters of HRT, initial TO and oscillation TS, were calculated and TO and TS were analyzed. All patients were divided into death group and survival group according to whether they were cardiac death or not. Provisions of 12-lead electrocardiogram pathological Q-wave guide ≥ 4 were large infarcts, ≤ 3 were small-area infarction. Comparison between groups using χ2 test. [Results] The positive rates of TO≥0 and TS≤2.5ms / RR in death group were significantly higher than those in survival group (P <0.01). The positive rate of TO≥0 and TS≤2.5ms / RR in large area AMI group was significantly higher than that in small area AMI group (P <0.01). [Conclusion] The changes of TO and TS values are closely related to the early cardiac death and infarct size in patients with AMI. Weakening or disappearing of HRT may be one of the sensitive indexes for predicting early malignant cardiac events in AMI patients.