Objective To evaluate the improvement of autonomic nervous system function and its clinical significance through comparison of heart rate turbulence ( HRT ) before and after percutaneous coronary intervention ( PCI ) in UAP patients with different stratification. Methods A total of 120 patients with unstable angina pectoris were selected and divided to low, middle and high risk group ( n = 20 ), each group was matched with 20 controls with drug treatment. All patients were examined by ambulatory electrocardiogram, and TO, TS values of HRT were calculated by two experienced cardiovascular physicians. Results TO, TS values of HRT in the high - risk group were significantly different from the other two groups, but no difference was noted between the middle - risk group and the low - risk group. After PCI treatment, TO values decreased while TS values increased ( P < 0. 05 ) . After 1 month of conventional drug therapy, improvement of TO and TS was only observed in the high - risk group ( P < 0. 05 ) . Furthermore, TO and TS were significantly improved in the PCI group compared to the drug group after 1 month treatment ( P <0. 05 ) . Conclusion This research indicates that the abnormalities of HRT parameters ( including TO and TS ) in UA patients are related to risk stratification. The improvement of TO and TS in all the groups, particularly in the high - risk group, after PCI suggests that HRT might be correlated with the severity of myocardial ischemia. For the drug therapy groups, TO and TS are only improved in the high risk group. Taken together, this study unveils a link between early intervention and improved prognosis in UA patients, especially those of in high risk.%目的 观察不稳定性心绞痛(UA)患者经皮冠脉介入治疗(PCI)前后窦性心率震荡(HRT)的变化,探讨UA患者PCI后自主神经功能改善情况及临床意义.方法 选择UA患者120例,进行危险分层,低、中、高危组各20例(PCI组,均行PCI治疗),每组设药物治疗对照者各20例(药物组);进行动态心电图检查,计算并比较HRT的参数震荡初始(TO)和震荡斜率(TS).结果 治疗前,高危组与中、低危组间TO、TS均有明显差异,中危与低危组之间TO、TS无明显差异.治疗后,PCI组患者HRT参数较术前均得到明显改善,且高危组TO、TS与其他两组比较,差异有统计学意义 (P＜0.05);药物组高危组较治疗前TO明显降低,TS明显升高,差异有统计学意义(P＜0.05);而中、低危组治疗前后TO、TS无明显变化.PCI组较药物组治疗后TO、TS改善明显(P＜0.05).结论 UA患者HRT指标明显异常,与危险分层有关.经过PCI治疗后TO、TS得到改善,尤其是高危组患者改善明显.而药物治疗组治疗前后HRT参数在高危组有所改善,而在中、低危组无明显改善.因此对UA患者尽早进行介入干预(尤其是对高危者)可有利于改善预后.
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