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目的:探讨经皮冠状动脉介入治疗(PCI)后心脏心率变异性(HRV)及QT离散度(QTd)的长期动态变化规律。方法:冠心病组32例,选择经冠状动脉造影证实并适合PCI的冠心病患者;对照组32例,选年龄性别匹配的经皮冠状动脉造影证实的非冠心病患者。所有入选者于PCI前,术后1周、1个月、3个月、6个月及1年进行HRV及QTd检测。结果:冠心病组HRV减低,PCI后1周HRV较术前减低更为明显,术后1,3个月HRV逐步升高,于6个月较术前改善最为明显,术后1年几乎达对照组水平;PCI前QTd较对照组明显增大,术后1周较术前缩小,1个月后明显缩小,以后变化不明显。结论:冠心病患者QTd增大,HRV减低,心脏自主神经功能受损。PCI后QTd短期内明显缩小,心脏自主神经功能PCI后早期进一步受损,但远期明显改善。
Objective: To investigate the long-term dynamic changes of heart rate variability (HRV) and QTd (QTd) after percutaneous coronary intervention (PCI). Methods: Thirty-two patients with coronary heart disease (CHD) were enrolled in the study. They were selected coronary artery disease patients who were confirmed by coronary angiography and were suitable for PCI. Thirty-two patients in the control group were enrolled in the study. All participants were tested for HRV and QTd before PCI, 1 week after surgery, 1 month, 3 months, 6 months and 1 year after PCI. Results: The HRV of CHD group was lower than that of preoperative one week after PCI. The HRV gradually increased at 1 month and 3 months after PCI, which showed the most obvious improvement at 6 months compared with preoperative, almost one year after operation The level of QTd in PCI group was significantly higher than that in control group. The level of QTd in PCI group was significantly lower than that in control group at 1 week after PCI, and was significantly reduced at 1 month after PCI. Conclusion: Patients with coronary heart disease QTd increased, HRV decreased, impaired cardiac autonomic function. QTd shortly after PCI was significantly reduced, cardiac autonomic function was further impaired in early PCI, but the long-term significantly improved.