心得安改善短效钙拮抗剂心痛定心率变异性的研究

探讨β受体阻滞剂心得安是否可以改善短效钙拮抗剂心痛定的心率变异性(HRV)。将101例观察对象随机分为对照组(只使用心痛定,n=49)和试验组(使用心痛定和心得安,n=52),分别在服药前及服药后7～10天做24h动态心电图检测,分析HRV指标:正常RR间期的标准差(SDNN)、每5min平均RR间期的标准差(SDANN)、相邻RR之差的均方根(RMSSD)、相邻RR之差>50ms占总窦性心搏的百分数(PNN50)、低频(LF)、高频(HF)、低频和高频比值(LF/HF)。结果:对照组在治疗后心率(HR)加快,SDNN、SDANN显著降低(分别为105.2±31.8msvs126.9±32.0ms、98.9±20.1msvs107.9±19.8ms,P均<0.05),LF、LF/HF升高(分别229.3±77.1Hzvs196.1±64.8Hz、5.4±1.9vs3.8±1.8,P均<0.05),HRV降低;而试验组在治疗后心率无明显改变,SDNN、SDANN、LF、HF升高(分别为140.1±29.8msvs129.1±31.9ms、127.8±21.1msvs108.2±20.1ms、209.8±70.1Hzvs197.3±65.1Hz、148.5±48.8Hzvs123.5±41.0Hz,P均<0.05),LF/HF降低(P<0.05),治疗组HRV升高。结论:心得安能改善短效钙拮抗剂心痛定的HRV。

Effects of Propanolol on Improved Heart Rate Variability Caused by Short-acting Calcium Antagonist Nifedipine

To approach whether beta blocker propanolol can improve heart rate variability (HRV) caused by short-acting calcium antagonist Nifedipine,101 objects were randomly divided into control group (nifedipine only, n=49) and treatment group (nifedipine plus propanolol, n=52). A 24-hour ambulatory electrocardiogram recording was obtained before and after 7 to 10 days treatment. The following parameters of HRV were analyzed: the standard deviation of all normal R-R intervals (SDNN), the standard deviation of mean 5-minute RR intervals (SDANN), the root mean square of successive differences between adjacent normal cycles (RMSSD), the percentage of absolute differences between successive RR intervals > 50 ms (PNN_ 50), the low-frequency (LF), the high-frequency (HF), and LF/HF. Results: In control group,after nifedine was used,heart rate (HR) increased, SDNN and SDANN obviously decreased (105.2±31.8 ms vs 126.9±32.0 ms,98.9±20.1 ms vs 107.9±19.8 ms,all P<0.05),LF and LF/HF increased (LF 229.3±77.1 Hz vs 196.1±64.8 Hz,LF/HF 5.4±1.9 vs 3.8±1.8,all P<0.05), and HRV decreased. In treatment group,after medicines were used,HR did not change obviously. SDNN, SDANN, LF and HF increased (140.1±29.8 ms vs 129.1±31.9 ms,127.8±21.1 ms vs 108.2±20.1 ms,209.8±70.1 Hz vs 197.3±165.1 Hz,148.5±48.8 Hz vs 123.5±41.0 Hz,all P<0.05),LF/HF ratio decreased (P<0.05), and HRV increased in treatment group. Conclusions:Propanolol can improve HRV caused by short-acting calcium antagonist nifedipine.