美托洛尔对舒张功能不良性心衰患者心率变异性的影响

Effects of metoprolol on heart rate variability in patients with diastolic heart failure

目的探讨舒张功能不良性心衰患者应用美托洛尔后心脏自主神经功能的变化。方法对照组常规抗心衰治疗,治疗组在常规抗心衰治疗的基础上加服美托洛尔,从12.5mg/d开始,缓慢增加剂量至25～50mg/d,治疗前和治疗3个月后分别进行心率变异性(HRV)分析。结果与对照组比较,治疗组治疗3个月后HRV指标SDNN、SDANN、rMSSD、PNN50均明显提高(P<0.01),且心功能改善明显优于对照组(P<0.05)。结论在常规治疗的基础上,加用美托洛尔治疗舒张功能不良性心衰,可改善心脏自主神经调节功能,可提高HRV,增强疗效。

Objective To investigate the functional changes of cardiac autonomic nervous in patients with diastolic heart failure （DHF） treated by metoprolol. Methods Patients in the control group received the traditional treatment against heart failure. The patients in the therapeutic group received metoprolol on the basis of traditional therapy. A initial dosage （12.5 rag/d）, and then increased the dosage gradually to （25-50 rag/d）. The parameters of heart rate variability （HRV） pretreatment and 3 months after treatment were analyzed. Results Compared with the control group, these HRV indexes of SDNN,SDANN, rMSSD and PNN50 in therapeutic group all i creased significantly at 3 months after treatment （P〈0.01）, and the improved cardiac function was apparently superior to the control group （P〈0.01）. Conclusion The metoprolol plus the traditional therapy for treatment of DHF patients can increase the HRV, enhance the treatment effect and improve prognosis of patients.