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采用心率变异性（ＨＲＶ）时域指标──２４ｈ心电图中全部窦性Ｒ－Ｒ间期标准差（ＳＤＮＮ），研究急性心肌梗塞（ＡＭＩ）患者ＨＲＶ改变及其与肌酸激酶同功酶（ＣＫ－ＭＢ）、心功能和住院期间病死率的关系。结果显示：ＡＭＩ后２～３ｄ的ＳＤＮＮ（６０．５３±２０．６０ｍｓ）较正常对照组（１３０．２０±３０．４１ｍｓ）显著降低（Ｐ＜０．００１），并与ＣＫ－ＭＢ峰值呈显著负相关（ｒ＝－０．４８，Ｐ＜０．０５）；服用美多心安者的ＳＤＮＮ显著高于未服者（６１．２７±１３．４４ｍｓＶＳ４７．５３±１１．２５ｍｓ，Ｐ＜０．０５）；心功能Ⅱ～Ⅳ级者ＳＤＮＮ显著低于Ⅰ级者（４９．７１±１８．１０ｍｓＶＳ６８．５２±１８．８０ｍｓ，Ｐ＜０．０１）；住院期间死亡者ＳＤＮＮ显著低于存活者（４２．２５±６．４５ｍｓＶＳ６２．５６＋２０．６３ｍｓ，Ｐ＜０．０１）；ＳＤＮＮ＜５０ｍｓ者的住院病死率显著高于＞５０ｍｓ者（３１％ＶＳ０，Ｐ＜０．０５）。提示ＡＭＩ早期心脏交感神经活动增强而迷走神经活动受抑制，其改变的程度与心功能损害和梗塞面积相关；ＡＭＩ早期测定ＨＲＶ可获得重要临床信息和有助于对患者作早期危险性的分层。
Using HRV time-domain-24h electrocardiogram (ECG) to investigate the relationship between HRV and creatine kinase isoenzymes (CK) in patients with acute myocardial infarction (AMI) -MB), cardiac function and mortality during hospitalization. The results showed that the SDNN (60.53 ± 20.60 ms) at 2 ~ 3d after AMI was significantly lower than that of the normal control group (130.20 ± 30.41 ms) (P <0.001), and the peak value of CK-MB was significantly (R = -0.48, P <0.05). SDNN was significantly higher in those who took metoprolol than those who did not (61.27 ± 13.44ms vs 47.53 ± 11.25ms, P <0.05) ); The SDNN of cardiac function Ⅱ ~ Ⅳ was significantly lower than that of grade Ⅰ (49.71 ± 18.10msVS68.52 ± 18.80ms, P <0.01); SDNN in hospitalized patients was significantly lower than that of survivors .25 ± 6.45msVS62.56 + 20.63ms, P <0.01). The in-hospital mortality of SDNN <50ms was significantly higher than that of> 50ms (31% VS0, P <0.05). It is suggested that cardiac sympathetic activity may be enhanced in the early stage of AMI and vagal activity may be inhibited. The degree of alteration may be associated with impaired cardiac function and infarct size. Early detection of HRV in AMI may acquire important clinical information and help to stratify patients at early risk.