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目的 分析老年冠心病患者自主神经功能变化及其与心血管事件(MACE)关联性。方法 纳入128例冠心病患者，采用动态心电图监测患者心率变异性，并评估患者自主神经功能变化，分析其与MACE的关系。结果 MACE患者24 h全部正常RR间期标准差(SDNN)、24 h内每5 min RR间期平均值标准差(SDANN)、相邻RR间期差值均方平方根(RMSSD)、24 h每5 min RR间期标准差平均值(SDNNindex)、相邻RR间期相差> 50 ms的个数占总心跳次数百分比(PNN50)、平均频域功率(FDPmean)、最小频域功率(FDPmin)、最大频域功率(FDPmax)明显低于非MACE患者(P<0.05)。MACE患者冠脉狭窄程度明显高于非MACE患者(P<0.05)。MACE与非MACE患者性别、年龄、体质量指数(BMI)、病程、吸烟史、饮酒史及高脂血症史无明显差异(P> 0.05)。Logistic回归分析显示，SDNN、RMSSD、SDNNindex、FDPmin与是否发生MACE无关(P>0.05)，时域指标中SDANN、PNN50和频域指标中FDPmean、FDPmax是MACE发生的保护因素，冠脉狭窄程度是MACE发生的风险因素(P<0.05)。受试者工作特征(ROC)曲线显示，时域指标SDANN、PNN50和频域指标FDPmean、FDPmax及冠脉狭窄程度评估冠心病患者发生MACE的曲线下面积(AUC)为0.757、0.770、0.750、0.688、0.810。结论 老年冠心病患者MACE发生风险与自主神经功能失衡可能存在一定关系，尤其是时域指标中SDANN、PNN50和频域指标中FDPmean、FDPmax下降有助于医师辅助评估MACE风险。
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基本信息:
中图分类号:R541.4
引用信息:
[1]王晖,陶媚,杨鹏会.老年冠心病患者自主神经功能变化及与心血管事件发生的关系[J].中国老年学杂志,2025,45(24):5898-5901.
基金信息:
秦皇岛市科学技术研究与发展计划(202301A078)