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急性心肌梗塞患者的压力反射敏感性测定 |
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Baroreflex sensitivity after acute myocardial infarction
范中杰 吴宁
Fan Zhongjie, Wu Ning
【摘要】 目的 探讨急性心肌梗塞(AMI)后压力反射敏感性(BRS)的临床意义。方
法 分析31例AMI患者和17例正常对照组的BRS、心率变异以及临床情况。结果 AMI
患者3周BRS明显小于17例正常对照组(10.7±7.2ms/mmHg vs. 4.2±1.5 ms/mmHg,P＜0.05)；
心肌梗塞患者随访中猝死2例，其BRS降低最明显； 心梗患者的BRS与心率变异各项指标无
相关性，与年龄、性别、超声射血分数、心肌酶谱等也无相关性；BRS有较大个体差异。
结论 BRS在心肌梗塞患者明显下降，并可作为患者的一项独立的预后指标；BRS与心率
变异是反映患者自主神经的二个不同方面。
【关键词】 压力反射敏感性 猝死，心脏 心肌梗塞 心率变异性
Baroreflex sensitivity after acute myocardial infarction Fan Zhongjie, Wu Ning. Department
of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese
Academy of Medical Sciences, Beijing 100730
【Abstract】 Objective To analyze the baroreflex sensitivity (BRS) and its clinical significance.
Methods The baroreflex sensitivity, heart rate variability and clinical situation of 31 patients with
acute myocardial infarction (AMI) and 17 normal controls were studied.Results BRS of the patients
in the third week after AMI was much lower than that of the normal controls (4.2±1.5ms/mmHg vs
10.7±7.2 ms/mmHg,P＜0.05). Two patients had sudden death during the follow-up, and their BRS
were the lowest. BRS of the patients had differences between each other and overlapped with that of
normal controls. It had no correlation with heart rate variability, age, sex, left ventricular ejective fraction
or serum peak creatine kinase.Conclusion BRS of the AMI patients was lower than that of the normal
controls, and was associated with the prognosis, and BRS and heart rate variability were two aspects of
the autonomic nervous system.
【Key words】 baroreflex sensitibity sudden death, cardiac myocardial infarction heart rate variability
急性心肌梗塞(AMI)后交感神经兴奋、迷走神经相对受抑制可促发室性心律失常［1］，
反之，迷走神经可使心电生理稳定［2］。反映交感-迷走这对自主神经系统平衡状态的心
率变异(HRV)可预测AMI后[1] [2] 下一页
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