增加心肌梗死患者心脏迷走神经张力的研究

目的 :观察小剂量东莨菪碱贴膜、培哚普利和美托乐尔对急性心肌梗死患者 ,卡托普利和培哚普利对陈旧性心肌梗死患者心脏迷走神经张力的影响。方法 :随机安慰剂对照 ,双盲法给药。治疗前后用心电图机和数字化 2 4hHolter记录测定心率变异性时域参数和频域参数。用苯肾上腺素法测定压力反射敏感性。结果 :经皮东莨菪碱治疗明显增加心率变异性时域参数和频域参数及压力反射敏感性。口服培哚普利和美托洛尔可提高急性心肌梗死患者迷走神经张力 ,降低交感神经张力 ,卡托普利和培哚普利可提高陈旧性前壁心肌梗死患者心脏迷走神经张力 ,降低交感神经张力。结论 :小剂量东莨菪碱透皮治疗、口服培哚普利、美托洛尔和卡托普利可显著增加心肌梗死患者心脏迷走神经张力 ,改善自主神经失衡

A study of increasing cardiac vagal tone in patients after acute myocardial infarction

Objective: To investigate whether transdermal scopolamine,oral perindopril, metoprolol and captopril, increased cardiac vagal activity in patients with myocardial infarction Methods: Random,double blind,placebo contrast methods were used Measures of heart rate variability(HRV) in patients given drugs or placebo were obtained by electrocardiograph and digital 24 hour Holter recording before and after treatment Baroreflex sensitivity(BRS) was performed using the phenylephrine method Results: Patients of acute myocardial infarction with transdermal scopolamine showed a significant increase in HRV time domain parameters and BRS after treatment( P <0 05) Cardiac vagal tone increasing and sympathetic tone withdrawal were present in patients with acute myocardial infarction after perindopril and metoprolol treatments( P <0 05) Cardiac vagal tone increasing and sympathetic tone withdrawal were present in patients with remote myocardial infarction after perindopril and captopril treatments( P <0 05) Conclusion: Low doses of transdermal scopolamine,oral perindopril, metoprolol and captopril, increased cardiac vagal activity improve autonomic indices in patients with myocardial infarction