培哚普利对充血性心力衰竭患者心率变异性的影响

目的：观察培哚普利对充血性心力衰竭（congestive heartfailure,CHF）心率变异性（heart rate variability,HRV）的影响,以探讨培哚普利治疗CHF的可能机制.方法：选择24例CHF患者,测量治疗前后HRV各项指标的变化,并与22名健康志愿者进行对照.结果：治疗前CHF患者HRV所有成分除低频功率（LF）/高频功率（HF）外较正常对照者均显著下降（P＜0.001）.治疗后培哚普利组正常R-R间期的标准差（SDNN）、节段平均R-R间期的标准差（SDANN）、总功率（TP）、极低频功率（VLF）、LF、HF增加非常显著（P＜0.01）,相邻R-R间期差值的均方根（RMSSD）显著增加（P＜0.05）,而标准差的平均值（SDNNindex）、相邻R-R间期差值大于50 ms记数占总R-R间期数的百分比（PNN50）有增加趋势,但无统计学意义（P＞0.05）;LF/HF有减小趋势,无统计学意义（P＞0.05）.结论：培哚普利可以改善心脏自主神经功能的失衡,其作用机制可能与降低交感神经张力、增加迷走神经张力有关.

Effect of Perindopril on Heart Rate Variability (HRV) in Patients with Congestive Heart Failure

Objective:To observe the effect of Perindopril on heart rate variability (HRV) in patients with congestive heart failure (CHF) in order to explore the possible mechanism behind the treatment of CHF by Perindoril.Methods:24 patients with CHF were selected and various indexes of HRV were recorded before and after the treatment,and compared with those in 22 normal control subjects.Results:Most of HRV parameters,except for LF/HF,in patient with CHF were significantly decreasd before the treatment when compared with those in normal controls (P<0.001),while after the treatment with Perindopril,SDNN,SDANN,TP,ULF,RMSSD,LF and HF were greatly increased (P<0.05 or P<0.01) compared with normal group.SDNN index and PNN50 showed an increasing trend,but without a significant difference(P>0.05);LF/HF went down unsignificantly (P>0.05).Conclusions:Perindopril could improve autonomic nervous system imbalance mainly by reducing sympathetic tension and increasing tension of vagus nerve.