不同剂量卡维地洛对急性心肌梗死患者QT离散度、JT离散度及心率变异性的影响

目的研究不同剂量卡维地洛对急性心肌梗死患者的QT离散度(QTd)、JT离散度(JTd)及心率变异性(HRV)的影响。方法根据卡维地洛用量将120例患者随机分为小剂量组(3.25⁶.25 mg,每日2次,n=68)和大剂量组(12.56.25 mg,每日2次,n=68)和大剂量组(12.5²5.0 mg,每日2次,n=52),疗程均3个月。治疗前后患者均接受长程心电图检查,记录QTd、JTd、HRV时域(SDNN、SDANN、rMSSD)、频域指标(LF、HF、LF/HF)。患者随访6个月。结果与治疗前比较,治疗3个月后,2组QTd、JTd、心率变异性的时域及频域指标均明显改善,且大剂量组较小剂量组更为明显(P<0.05,P<0.01)。6个月内2组不良心血管事件发生率比较差异无统计学意义(P>0.05)。结论大剂量卡维地洛能进一步减小急性心肌梗死患者QTd、JTd及改善HRV,但并不降低不良心血管事件发生率。

Different doses of carvedilol for improving QT,JT dispersion and heart rate variability in patients with acute myocardial infarction

Objective To explore the effects of different doses of carvedilol for improving QT,JT dispersion and heart rate variability in patients with acute myocardial infarction（AMI）.Methods According to carvedilo]dosage of 120 patients were randomly divided into low-dose group（3.25-6.25 mg,twice a day,n=68）and high-dose group（12.5-25mg,twice a day,n=52）,treatments course were three months.Before and after treatment patients received long-ECG recording QTd,JTd,HRV time domain（SDNN,SDANN,rMSSD）,frequency domain（LF,HF,LF/HF）.Patients were followed for 6 months.Results Compared with before treatment,after 3 months of treatment,two groups＇ QTd,JTd,HRV time domain and frequency domain indices were significantly improved,and the high-dose group was better tian smaller doses group（P0.05,P0.01）.within 6 months adverse cardiovascular events in 2 group was not significant different（P0.05）.Conclusion High doses of carvedilol in patients with acute myocardial infarction can further reduce QTd,JTd and improve HRV,but did not reduce the incidence of adverse cardiovascular events