比索络尔对老年冠心病心肌缺血的治疗价值及对心率变异性影响的研究

目的 :探讨选择性 β受体阻滞剂比索络尔对老年冠心病心肌缺血的治疗价值及对心率变异性的影响。方法 :选择性 β受体阻滞剂比索络尔治疗老年性冠心病 5 2例 ,用三通道动态心电图进行 2 4h监测 ,同时进行心率变异性分析。结果 :应用博苏治疗 12周后 ,博苏可减少心肌缺血次数和时间 ,增加 2 4h平均正常NN间期 ,引起迷走张力活动增加 ,爱丁堡指数即差值 >5 0ms的百分比增加 64 3 % ,相邻RR间期差值的标准差的均方根增加 45 2 % ,不引起 2 4h连续正常R_R间期的标准差和 2 4h所有 5min正常R_R间期均值的标准差的明显改变。结论 :博苏可以减少心肌缺血次数和时间 ,增加 2 4h平均正常NN间期 ;博苏引起迷走张力活动增加。可降低心性猝死率和心血管事件的发生率 ,提高患者的存活质量

Treatment value and variety of heart rate variability after Beta-Blocker therapy in patients with coronary artery disease

Objective: To study the treatment value and variety of heart rata variability after Beta_Blocker therapy for older's coronary attery disease (CAD) in elders.Methods: 52 older patients with coronary heart disease were treated by bisoprolol,a cardioselective beta_blocker,monitored by 24 hours dynamic electrocardiogram,analysised by heart rate variability with time domain method(TD).Results: After 12 weeks treatment,bisoprolol decreased the ischemical attacts and times;increased 24_hour average normal RR;Measures of tonic vagal activity were increased significantly with bisoprolol;increase for the percentage of differences>50 msec between adjacent NN intervals (PNN50,P<0.05) and increase for root mean square differences(rMSSD,P<0.05).By contrast,standard deviations(DS) of all NN over a 24_hour period (SDNN) and SD of means of 5_minute blocks of NN related to total (SDANN) were not significantly nodified by bisoprolol(P>0.05).Conclusion: HRV,assessed by TD,is modified differently according to the specific type of Beta_Blocker monotherapy used.These modifications could have prognostic importance.Measures of tonic vagal activity were increased significantly with bisoprolol.