新活素对急性心衰患者心率变异性的影响

目的观察新活素——冻干重组人脑利钠肽(Lyophilized Recombinant Human Brain Natriuretic Peptide,Lrh-BNP)治疗急性失代偿心力衰竭(Acute decompensated heart failure,ADHF)对心脏自主神经功能的影响。方法对照组49例,进行基础抗心衰治疗;Lrh-BNP组45例,在基础抗心衰治疗上静脉注射Lrh-BNP 24 h。所有患者治疗前后均进行24 h Holter检查,对Lrh-BNP治疗前后及对照组进行心率功率谱时域和频域分析。结果Lrh-BNP组治疗后心率变异性(HRV)值较对照组显著改善,其中时域指标:全部正常R-R间期的标准差(SDNN)、每5 min R-R间期均值的标准差(SDANNI)、SDNN的均值(SDNNI)、正常相邻R-R间期差值的均方根RMSSD、正常相邻R-R间期差值>50 ms的百分比(PNN50)、心率均显著改善(P<0.05);频域指标:总频谱(TF)、低频(LF)和高频(HF)亦明显改善(P<0.05)。结论Lrh-BNP可改善ADHF患者的心率变异性。

Effects of Lyophilized Recombinant Human Brain Natriuretic Peptide on Heart Rate Variability in Acute Decompensated Heart Failure

Objective To study the effect of lyophilized recombinant human brain natriuretic peptide(Lrh-BNP) on heart rate variability in acute decompensated heart failure(ADHF).Methods Forty nine cases with ADHF were treated by routine measure(as control).Forty five cases were treated with Lrh-BNP for 24 hours based on the routine measure.The heart rate power spectral density and time-domain were analyzed with 24 hour electrocardiographic monitoring before and after using Lrh-BNP.Results Compared with the control group,time-domain analysis in Lrh-BNP after the treatment revealed a significant improved in SDNN,SDANNI,SDNNI,RMSSD,PNN50(P<0.05).Heart Rate and frequency domain analysis revealed marked improve of total,low and high frequency components(P<0.05).Conclusions Lrh-BNP can significantly improve the heart rate variability in ADHF.