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目的:观察序贯再通经皮冠状动脉介入(PCI)治疗对急性ST段抬高型心肌梗死(STEMI)患者心率变异性的影响。方法:选择潍坊医学院附属益都中心医院2015年10月至2017年10月收治的STEMI患者180例为观察对象，采用随机数字表法分为序贯再通经皮冠状动脉介入治疗(sPCI)组(观察组)90例和传统的直接PCI(pPCI)组(对照组)90例。比较两组患者在介入治疗梗死相关动脉开通后2周心率变异性指标的变化。结果:观察组、对照组心肌充血分级(MBG)3级血流发生率差异有统计学意义(77.78%比63.33%，χn 2＝4.51，n P＝0.03)。观察组、对照组术后2周全部窦性心搏RR间期的标准差(SDNN)<70 mm的发生率差异有统计学意义(10.00%比23.33%，χn 2＝5.69，n P＝0.02)。以观察组为变量对2周SDNN<70 mm的影响进行多因素logistic回归分析，结果其n OR值为0.36，95%n CI 0.16～0.85，n P＝0.02。影响SDNN<70 mm发生率的其他因素：心肌灌注MBG 3水平(n OR＝0.45，95%n CI：0.16～0.95，n P＝0.03)、再灌注时间(n OR＝2.65，95%n CI：1.06～5.98，n P＝0.04)、入院血糖水平(n OR＝1.96，95%n CI：1.04～7.71，n P＝0.04)、血清肌钙蛋白I(TnI)值(n OR＝2.06，95%n CI：1.03～5.68，n P＝0.04)及心脏功能水平(n OR＝2.18，95%n CI：1.08～6.89，n P＝0.04)。n 结论:序贯再通PCI治疗在改善STEMI患者心肌血流灌注的同时可提高心率变异性指标和降低SDNN<70 mm的发生率，优于传统的直接PCI治疗。“,”Objective:To explore the effect of sequel reperfusion percutaneous coronary intervention (PCI) therapy on heart rate variability (HRV) during myocardial reperfusion in patients with acute ST segment elevation myocardial infarction(STEMI).Methods:With a randomly case controlled study method, 180 patients with STEMI in Yidu Central Hospital Affiliated to Weifang Medical College were selected as study objects, and they were randomly divided into two groups: sequel recanalization PCI(sPCI) group(observation group) and conventional primary PCI(pPCI) group(control group), with 90 cases in each grouop.The rate of SDNN<70 mm of the two groups and other indicators of HRV were observed at 14 d after successful PCI.Results:There was statistically significant difference between the two groups in MBG3(77.78% vs.63.33%, χ n 2=4.51, n P=0.03). There was statistically significant difference between the two groups in the incidence of SDNN<70 mm at 14 d after PCI(10.00% vs.23.33%, χn 2=5.69, n P=0.02). If sequel recanalization PCI was served as a variable for predicting SDNN<70 mm, the results of Logistic regression analysis showed that odds ratio (n OR) value was 0.36, 95% confidence interval (n CI) was 0.16-0.85, n P=0.02.The other factors that affected the incidence rate of SDNN<70 mm were the level of MBG3(n OR=0.45, 95%n CI: 0.16~0.95, n P=0.03), time-to-reperfusion(n OR=2.65, 95%n CI: 1.06~5.98, n P=0.04), blood sugar level of admission (n OR=1.96, 95%n CI: 1.04~7.71, n P=0.04), TnI value(n OR=2.06, 95%n CI: 1.03~5.68, n P=0.04), heart function(n OR=2.18, 95%n CI: 1.08~6.89, n P=0.04).n Conclusion:The sequel recanalization PCI may be better than conventional PCI for the patients with STEMI in obtaining myocardial blush grades.Meanwhile, it can increase the indicators of HRV and decrease the incidence rate of SDNN<70 mm.