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目的探讨心率减速力对急性心肌梗死患者的预警价值。方法选取200例发病≤两周的急性心肌梗死后窦性心律的患者为AMI组和200例非急性心肌梗死患者为非AMI组,对两组均记录24 h动态心电图,获取心率减速力值和心率加速力值,并进行预警分析。结果 AMI组一支病变52例,两支病变98例,三支病变50例;非AMI组一支病变98例,两支病变68例,三支病变34例。AMI组一年病死率:心率减速力值≥4.5 ms为2.00%,2.6~4.4 ms为7.50%,≤2.5 ms为10.05%,差异有统计学意义(P<0.01);非急性心肌梗死组心率减速力各值中均无死亡病例。心率加速力值≤-7.0 ms,除AMI组一年病死率为1.00%外,余均无死亡病例。结论通过测定心率减速力值,能定量、单独分析和评估迷走神经作用的强度,对AMI猝死高危人群筛选与预警有较强的实用价值。
Objective To investigate the early warning value of heart rate deceleration in patients with acute myocardial infarction. Methods Two hundred and twenty patients with sinus rhythm after acute myocardial infarction ≤ 2 weeks were selected as AMI group and 200 patients with non-acute myocardial infarction as non-AMI group. All patients were recorded 24 hours dynamic electrocardiogram, Heart rate acceleration force, and early warning analysis. Results There were 52 lesions in one AMI group, 98 lesions in two lesions and 50 lesions in three lesions. In the non AMI group, there were 98 lesions in one area, 68 lesions in two lesions and 34 lesions in three lesions. In the AMI group, the one-year mortality rate was 2.00% for heart rate deceleration ≥4.5 ms, 7.50% for 2.6 to 4.4 ms, and 10.05% ≤2.5 ms, with significant difference (P <0.01). In non-AMI group, heart rate There was no death in each value of deceleration force. Heart rate acceleration force ≤-7.0 ms, except for the AMI group, the one-year mortality rate was 1.00%, the rest were no deaths. Conclusion The determination of heart rate deceleration force value can quantitatively and separately analyze and evaluate the intensity of vagal nerve function and has strong practical value for screening and early warning of AMI patients at high risk of sudden death.