美托洛尔剂型差异对不稳定型心绞痛患者QT间期离散度及心率变异性的影响

目的 探讨美托洛尔剂型差异对不稳定型心绞痛患者QT间期离散度及心率变异性的影响.方法 将本院2014年3月至2016年3月收治的88例不稳定型心绞痛患者随机分为平片组和缓释片组,每组44例.在常规冠心病治疗的基础上,平片组患者给予口服酒石酸美托洛尔片治疗,缓释片组患者给予口服琥珀酸美托洛尔缓释片治疗.两组患者均以1个月为一疗程,连续治疗3个疗程,比较两组治疗前后QT间期离散度及心率变异性的差异.结果 治疗30 d后,缓释片组患者SDNN、SDANN、RMSSD、PNN50分别为(127.26±31.81) ms、(120.92±34.04) ms、(52.33±10.56) ms、(19.21±3.30)％,明显高于平片组的(111.64±27.29) ms、(107.17±28.54)ms、(42.15±7.42) ms、(13.78±4.36)％,差异均有统计学意义(均P＜ 0.05);缓释片组患者QTd、QTcd分别为(38.46±11.02) ms、(34.43±10.17) ms,明显低于平片组的(53.55±15.36)ms、(43.07±12.23) ms,差异均有统计学意义(均P＜0.05);治疗3个月后,缓释片组临床控制率和总有效率分别为36.36％、90.91％,明显高于平片组的13.64％、72.73％,差异均有统计学意义(均P＜ 0.05).结论 美托洛尔缓释片治疗不稳定型心绞痛的临床疗效及对QT间期离散度及心率变异性的影响均明显优于美托洛尔平片,更有利于改善患者的预后.

Effects of different dosage forms of metoprolol on heart rate variability and QT interval dispersion in patients with unstable angina pectoris

Objective To investigate the effects of different dosage forms of metoprolol on heart rate variability and QT interval dispersion in patients with unstable angina pectoris.Methods 88 patients with unstable angina peetoris treated at our hospital from March,2014 to March,2016 were divided into a flat plate group and a sustained release tablets group,44 cases for each group.In the addition of conventional treatment of coronary heart disease,the flat plate group was treated with metoprolol tartrate tablets and the sustained release tablets group with metoprolol succinate sustained-release tablets.The two groups were treated three courses,1 months as a treatment course.The differences of QTd and HRV before and after treatment were compared between two groups.Results 30 d after treatment,the SDNN,SDANN,RMSSD,and PNN50 of the sustained release tablets group were (127.26±31.81) ms,(120.92±34.04)ms,(52.33±10.56)ms,and (19.21±3.30)％ and those of the flat film group were(111.64±27.29)ms,(107.17±28.54)ms,(42.15±7.42)ms,and (13.78±4.36)％ (all P ＜ 0.05).The QTd and QTcd were (38.46±11.02)ms and (34.43±10.17)ms in the sustained release tablets group and were (53.55±15.36)ms and (43.07±12.23)ms in the flat film group (all P ＜ 0.05).3 months after treatment,the clinical control rate and total effective rate were 36.36％ and 90.91％ in the sustained release tablets group and were 13.64％ and 72.73％ in the flat film group (all P ＜ 0.05).Conclusions Compared with metoprolol fiat piece,metoprolo tattrate sutaineol release tablets has a better clinical efficacy in patients with unstable angina pectoris,it can improve the patients' prognosis and QTd and HRV levels.