硝苯地平缓释片对于CHF合并室性心律失常患者血流变、中心与外周动脉压以及HRV的影响

目的:研究硝苯地平缓释片对慢性心力衰竭(CHF)合并室性心律失常(VA)患者血流变、中心动脉压(CAP)与外周动脉压(PAP)、以及心率变异性(HRV)的影响。方法:本院2015年~2018年收治的90例CHF+VA患者被随机均分为常规治疗组和硝苯地平组(在常规治疗组基础上加用硝苯地平缓释片),两组均治疗30d。观察比较两组治疗前后CAP、PAP、血液流变学指标、HRV指标,以及治疗总有效率。结果:与常规治疗组比较,硝苯地平组治疗后CAP、PAP(80.46±9.39/76.32±9.27)mmHg比(72.81±10.35/70.23±9.16)mmHg]、全血黏度高切(4.12±0.95)mPa/s比(3.02±1.09)mPa/s]、全血黏度低切(10.96±2.25)mPa/s比(9.01±2.13)mPa/s]、血浆纤维蛋白原水平(4.02±0.73)g/L比(3.11±0.67)g/L]和血浆黏度(1.62±0.31)mPa/s比(1.30±0.28)mPa/s]均显著降低,24h正常RR间期标准差SDNN,(92.68±9.29)ms比(104.12±11.96)ms]、24h每5min正常RR间期的平均值标准差SDANN,(98.31±10.52)ms比(106.79±11.87)ms]、所有相邻的正常RR间期之差的均方根rMSSD,(29.28±5.92)ms比(37.96±6.14)ms]、所有相邻的正常RR间期差值>50ms的心博数占24h总RR间期数的百分比PNN50,(15.87±2.39)%比(20.58±3.19)%]、高频和低频均显著升高,P<0.05或<0.01。结论:硝苯地平缓释片能够显著降低CHF+VA患者中心动脉压、外周动脉压及血液流变学指标,改善心率变异性。

Influence of nifedipine sustained-release tablet on hemorheological indexes,central and peripheral arterial pressure and HRV in CHF+ventricular arrhythmia patients

Objective:To study influence of nifedipine sustained-release tablet on hemorheological indexes,central arterial pressure(CAP),peripheral arterial pressure(PAP)and heart rate variability(HRV)in patients with chronic heart failure(CHF)complicated ventricular arrhythmia(VA).Methods:A total of 90 CHF+VA patients treated in our hospital from 2015 to 2018 were randomly and equally divided into routine treatment group and nifedipine group(received nifedipine sustained-release tablet based on routine treatment group),both groups were treated for 30d.CAP,PAP,hemorheological indexes and HRV indexes before and after treatment,and total effective rate were observed and compared between two groups.Results:Compared with routine treatment group after treatment,there were significant reductions in CAP,PAP(80.46±9.39/76.32±9.27)mmHg vs.(72.81±10.35/70.23±9.16)mmHg],whole blood high shear viscosity(4.12±0.95)mPa/s vs.(3.02±1.09)mPa/s],whole blood low shear viscosity(10.96±2.25)mPa/s vs.(9.01±2.13)mPa/s],plasma fibrinogen level(4.02±0.73)g/L vs.(3.11±0.67)g/L]and plasma viscosity(1.62±0.31)mPa/s vs.(1.30±0.28)mPa/s],and significant rise in standard deviation of normal to normal RR intervals calculated over the 24 h periodSDNN,(92.68±9.29)ms vs.(104.12±11.96)ms],standard deviation of normal to normal RR intervals in all 5 min segments of the entire recordingSDANN,(98.31±10.52)ms vs.(106.79±11.87)ms],root-mean square of differences between successive normal to normal intervalsrMSSD,(29.28±5.92)ms vs.(37.96±6.14)ms],adjacent normal RR interval difference>50ms stroke accounted for a percentage of 24h total RR intervalPNN50,(15.87±2.39)%vs.(20.58±3.19)%],high frequency and low frequency,P<0.05 or<0.01.Conclusion:Nifedipine sustained-release tablet can significantly reduce central and peripheral arterial pressure,hemorheological indexes,and improve heart rate variability in CHF+VA patients.