β-受体阻断剂和血管紧张素转换酶抑制剂对心肌梗死患者心率变异影响的比较

为了解β－受体阻断剂和血管紧张素转换酶抑制剂（ＡＣＥＩ）对心肌梗死患者心率变异（ＨＲＶ）的影响，采用惠普系列双通道动态心电图机对５３例急性心肌梗死（ＡＭＩ）和３２例陈旧性心肌梗死（ＯＭＩ）患者进行了ＨＲＶ分析。β－受体阻断剂治疗的ＡＭＩ患者（Ｂ组）与对照组（常规治疗的ＡＭＩ患者即Ｃ组）相比，２４ｈＲＲ间期总体标准差（ＳＤＮＮ）、相邻ＲＲ间期大于５０ｍｓ的百分比（ｐＮＮ５０）均增加（７．２６±３．４４ｍｓｖｓ４．２７±２．０１ｍｓ，１２６．３４±３０．０５ｖｓ９１．４８±２９．２１，Ｐ均＜０．０５），高频带（ＨＦ）增大（８．５３±１．９７ｍｓ２／Ｈｚｖｓ６．７２±２．０８ｍｓ２／Ｈｚ，Ｐ＜０．０５），低频带（ＬＦ）降低（１２．６４±３．０５ｍｓ２／Ｈｚｖｓ１５．３１±４．２１ｍｓ２／Ｈｚ，Ｐ＜０．０１）。ＡＣＥＩ治疗的ＡＭＩ患者（Ａ组）与对照组（ｃ组）相比，ｐＮＮ５０增加（１２３．５９±２７．６３ｖｓ９１．４８±２９．２１，Ｐ＜０．０５），低频与高频的比值降低（２．１３±１．０５ｖｓ２．３５±０．８７，Ｐ＜０．０５），其中伴有心力衰竭者与不伴心力衰竭者相比ＨＲＶ改善较显著。ＡＣＥＩ和β－受体阻断剂对ＯＭＩ患者?

Comparative Analysis of β Blockers and ACE Inhibitors on Heart Rate Variability in Patients With Acute and Old Myocardial Infarction

To investigate whether β blockers and ACE inhibitors (ACEI) therapy modulate heart rate variability (HRV) in the patients with acute myocardial infarction (AMI) and old myocardial infarction (OMI).HRV was studied in 53 patients with AMI and 32 patients with OMI.The results showed that β blockers and ACEI increased HRV in AMI.Compared with placebo,β blockers increased the SD of all normal RR intervals (SDNN) from 427±2.01 to 726±3.44 (P<0.05),increased the percent of adjacent RR intervals differing by more than 50 ms in the entire recording (pNN50) from 91.98±29.21 to 126.34±30.05(P<0.05),High frequency power and low frequency power were changed from 6.74±2.08 to 8.53±1.97 (P<0.05),and from 15.31±4.21 to 12.64±3.05 (P<0.05).ACEI increased pNN50 from 91.48±29.21 to 123.59±27.63 (P<0.05),the ratio of LF to HF decreased from 2.35±0.87 to 2.13±1.05 (P<0.05),in patients associated with cardiac insufficiency,HRV was enhanced more obviously than those with no cardiac failure.There were little change of HRV in OMI after the treatment of β blockers or ACEI.It is suggested that these two kinds of drugs may increase HRV in AMI,and improve the patients prognosis.