心率变异性指标对ACS患者PCI术后短期预后的预测价值

doi:10.3969/j.issn.1671-7171.2026.03.010

摘要
图/表
参考文献
相关文章 (15)

全文: PDF (1272 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要 【目的】探讨心率变异性(HRV)指标对急性冠脉综合征(ACS)患者经皮冠状动脉介入治疗(PCI)术后短期预后的预测价值。【方法】选取2022年3月至2024年5月在本院行PCI的157例ACS患者,所有患者均口服阿托伐他汀钙片,根据治疗后6个月内是否发生主要不良心血管事件(MACE)将患者分为对照组(未出现MACE,n=125)和观察组(出现MACE,n=32)。比较两组治疗前后的HRV指标[正常心搏之间的间隔(NN间期)的标准差(SDNN)、NN间期差的均方根(rMSSD)、低频(LF)、高频(HF)、近似熵(ApEn)和样本熵(SampEn)、SD1、SD2]、24 h动态心电图指标[震荡斜率 (TS)、震荡初始(TO)、24 h QT间期变异性(24hQTV)、24 h连续5 min正常R-R间期标准差(SDANN-index)]、Gensini评分,采用Pearson相关性分析Gensini评分与HRV指标相关性,多因素Logistic回归分析ACS患者发生MACE的危险因素。【结果】观察组SDNN、LF、SD2、Gensini评分高于对照组,rMSSD、HF、SD1低于对照组,差异有统计学意义(P<0.05)。观察组TS、24hQTV、SDANN-index低于对照组,TO高于对照组,差异均有统计学意义(P<0.05)。Pearson相关性分析显示,Gensini评分与SDNN、LF、SD2呈正相关(r=0.266、0.232、0.258,均P<0.05),与rMSSD、HF、SD1呈负相关(r=－0.218、－0.181、－0.242,均P<0.05)。多因素Logistic回归分析显示,SDNN、LF、SD2与ACS患者PCI术后发生MACE呈正相关(P<0.05),而TS、rMSSD、HF、SD1、24hQTV、SDANN-index与ACS患者PCI术后发生MACE呈负相关(P<0.05)。【结论】HRV对ACS患者PCI术后短期预后的预测价值较高,其在评估患者病情严重程度和治疗效果方面具有重要价值。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	夏益兰
	杨为亚
	孙玲

关键词 ：冠状动脉疾病, 急性病, 综合征, 经皮冠状动脉介入治疗, 心率

Abstract：【Objective】 To explore the changes of heart rate variability (HRV) indicators in patients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI) treated with oral atorvastatin calcium tablets, and to evaluate the predictive value of HRV indicators in short-term prognosis. 【Methods】 A total of 157 ACS patients who underwent PCI in our hospital from March 2022 to May 2024 were selected. All patients took atorvastatin calcium tablets orally. According to whether major adverse cardiovascular events (MACE) occurred within 6 months after treatment, the patients were divided into a control group (no MACE occurred, n=125) and an observation group (MACE occurred, n=32). HRV indicators [standard deviation of normal-to-normal intervals (SDNN), root mean square of the differences between successive normal-to-normal intervals (rMSSD), low frequency (LF), high frequency (HF), approximate entropy (ApEn), sample entropy (SampEn), SD1, SD2] before and after treatment, 24-hour dynamic electrocardiogram indicators [turbulence slope (TS), turbulence onset (TO), 24-hour QT interval variability (24hQTV), standard deviation of the average normal R-R intervals for successive 5-minute segments (SDANN-index)], and Gensini score were compared between the two groups. Pearson correlation analysis was used to analyze the correlation between Gensini score and HRV indicators, and multivariate Logistic regression analysis was used to analyze the risk factors for MACE in ACS patients. 【Results】 The SDNN, LF, SD2 and Gensini scores in the observation group were higher than those in the control group, while rMSSD, HF and SD1 were lower than those in the control group, with statistically significant differences (P<0.05). The TS, 24hQTV and SDANN-index in the observation group were lower than those in the control group, and TO was higher than that in the control group, with statistically significant differences (P<0.05). Pearson correlation analysis showed that Gensini score was positively correlated with SDNN, LF and SD2 (r=0.266, 0.232, 0.258, all P<0.05), and negatively correlated with rMSSD, HF and SD1 (r=-0.218, -0.181, -0.242, all P<0.05). Multivariate Logistic regression analysis showed that SDNN, LF and SD2 were positively correlated with the risk of MACE in ACS patients (P<0.05), while rMSSD, HF, SD1, 24hQTV and SDANN-index were negatively correlated with the risk of MACE (P<0.05). 【Conclusion】 HRV has high value in predicting the short-term prognosis of ACS patients after PCI, and it plays an important role in evaluating the severity of patients' condition and treatment effect.

Key words： Coronary Artery Disease Acute Disease Syndrome Percutaneous Coronary Intervention Heart Rate

收稿日期: 2025-12-09

中图分类号:

R543.31

通讯作者: * E-mail:952891860@qq.com

引用本文:

夏益兰, 杨为亚, 孙玲. 心率变异性指标对ACS患者PCI术后短期预后的预测价值[J]. 医学临床研究, 2026, 43(3): 387-390.
XIA Yilan, YANG Weiya, SUN Ling. Application Value of Heart Rate Variability Indicators in Predicting Short-Term Prognosis of ACS Patients after PCI. JOURNAL OF CLINICAL RESEARCH, 2026, 43(3): 387-390.

链接本文:

http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2026.03.010 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2026/V43/I3/387

[1] HUANG C. Effect of new cardiac rehabilitation mode on cardiac function, mental state and quality of life of postoperative patients with acute myocardial infarction treated with atorvastatin calcium tablet[J].Eur Rev Med Pharmacol Sci,2023,27(8):3406-3419.
[2] LI R H, SHI T T, XING E P, et al.Atorvastatin calcium tablets on inflammatory factors, hemorheology and renal function damage indexes in patients with diabetic nephropathy[J].Pak J Med Sci,2021,37(5):1392-1396.
[3] 苏冠丽, 孔丹丹, 王乐, 等. 阿托伐他汀预处理对PCI治疗的ACS患者血脂及 cTnI、CK-MB水平的影响[J].新疆医科大学学报,2021,44(1):65-69.
[4] 周东杨,陈静,路畅,等. 心率变异性与扩大的血管周围间隙脑部分布关系研究[J].中国全科医学,2023,26(11):1348-1354.
[5] 中华医学会心血管病学分会介入心脏病学组,中国医师协会心血管内科医师分会血栓防治专业委员会,中华心血管病杂志编辑委员会.中国经皮冠状动脉介入治疗指南(2016)[J].中华心血管病杂志, 2016, 44(5): 382-400.
[6] 王荣荣,田俊萍. 急性冠脉综合征患者血清钙与心血管预后的关系[J].首都医科大学学报,2023,44(1):154-160.
[7] AYDIN G,GOLCUK E,BAHAT G. Which treatment strategy is preferred in the octogenarians with acute coronary syndrome?[J].J Pak Med Assoc,2023, 73(9): 1800-1804.
[8] 徐智虎. 阿托伐他汀联合利伐沙班对急性冠脉综合征患者PCI术后有效性及对心血管事件的影响[J].中国老年学杂志,2022,42(22):5420-5423.
[9] 张艳红,崔萌,江宁. 养心饮汤增减对老年急性冠脉综合征经皮冠状动脉介入术后外周血CD40、NF-κB表达的影响[J].中华中医药学刊,2022,40(7):71-73.
[10] ARAU′JO-PEREIRA M, ANDRADE B B. Atorvastatin to reduce bacillary load and attenuate lung damage in TB patients[J].Int J Tuberc Lung Dis,2023,27(12):880-881.
[11] SALLAM M,HASSAN H,CONNOLLY D, et al. Commencement of atorvastatin and ezetimibe immediately in patients presenting with acute coronary syndrome[J].Eur Cardiol,2024,19: e22.
[12] 刘左玲. 心率变异性指标在接受PCI急性冠脉综合征患者短期预后的预测价值[J].中国老年学杂志,2019,39(17):4129-4132.
[13] 刘前,邓倩,周静,等. 依达拉奉右莰醇联合阿托伐他汀治疗老年急性脑梗死的临床疗效及对脑血流动力学的影响[J].中国老年学杂志,2023,43(2):276-279.
[14] 陈志洁,汪春庆,康小琴,等. HRV参数与AMI患者梗死部位、病变血管支数及预后的关系[J].影像科学与光化学,2022,40(4):804-809.
[15] 刘冬,张慎和,郭菲. 重度颈动脉狭窄经吲哚布芬与阿托伐他汀治疗后的CTP成像评价[J].中国实用神经疾病杂志,2023,26(9):1113-1117.