目的 探讨24h动态心电图参数对急性心肌梗死(AMI)患者发生恶性心律失常(MVA)的预测价值.方法 选取2021 年3 月至2023 年5 月收治的94 例AMI患者为研究对象,全部患者均行24h动态心电图检测,并记录患者住院期间MVA发生情况,对比发生、未发生MVA患者24h动态心电图参数[24 h QT间期变异性(24 h QTV)、连续正常RR间期标准差(SDNN)、每5 min RR间期平均值的标准差均值(SDNN-Index)、每5 min RR间期平均值的标准差(SDANN)],绘制受试者工作曲线(ROC),分析24h动态心电图参数预测AMI患者MVA发生的价值.结果 94 例AMI患者住院期间发生MVA 27 例,发生率为28.72%.发生MVA的AMI患者24 h QTV、SDNN、SDNN-Index及SDANN均较未发生MVA患者低,差异均有统计学意义(均P<0.05).绘制ROC曲线发现,24 h QTV、SDNN、SDNN-Index、SDANN单独及联合检测预测AMI患者MVA发生的AUC均>0.70,均有一定预测价值,其中联合检测的预测价值最高.结论 24h动态心电图参数对AMI患者发生MVA具有较高的预测价值,多参数联合预测有利于早期采取防治措施,预防MVA发生.
Predictive value of 24-hour dynamic electrocardiogram parameters for occur-rence of MVA in patients with acute myocardial infarction
Objective To explore the predictive value of 24-hour dynamic electrocardiogram parameters for malignant arrhythmia(MVA)in patients with acute myocardial infarction(AMI).Methods 94 AMI patients admitted to the hospital from March 2021 to May 2023 were selected,and the occurrence of MVA during hospitalization was evaluated and recorded;All patients underwent 24-hour dynamic electrocardiogram testing,recording relevant electrocardiogram parameters 24-hour QT interval variability(24-hour QTV),standard deviation of continuous normal RR intervals(SDNN),mean standard deviation of RR intervals every 5 minutes(SDNN In-dex),and standard deviation of RR intervals every 5 minutes(SDANN).The 24-hour dynamic electrocardiogram parameters of patients with and without MVA were compared,and the subject working curve(ROC)was drawn,the value of analyzing 24-hour dynamic elec-trocardiogram parameters in predicting the occurrence of MVA in AMI patients.Results During the hospitalization of 94 AMI pa-tients,27 cases of MVA occurred,with an incidence rate of 28.72%;The24-hour QTV,SDNN,SDNN Index,and SDANN levels in pa-tients with MVA AMI were significantly lower than those in patients without MVA AMI(P<0.05);Drawing the ROC curve,it was found that 24-hour QTV,SDNN,SDNN Index,and SDANN alone and in combination predicted AUC for MVA occurrence in AMI pa-tients,all of which were greater than 0.70,all of which had certain value,with the combined detection having the highest predictive val-ue.Conclusion The 24-hour dynamic electrocardiogram parameters have high predictive value for the occurrence of MVA in AMI patients.In the future,multiple parameters can be combined for observation to take early preventive measures and prevent the occur-rence of MVA.
Acute myocardial infarctionMalignant arrhythmia24-hour dynamic electrocardiogramDiagnostic value
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