地尔硫与美托洛尔对老年陈旧性心肌梗死患者心率变异的影响

Effect of Diltiazem and Metoprolo on Heart Rate Variability in Aged Patients with Remote Myocardial Infarction

目的观察地尔硫及美托洛尔对老年陈旧性心肌梗死患者心率变异的影响,评价其对老年陈旧性心肌梗死患者的心肌保护作用。方法92例老年陈旧性心肌梗死患者,分为地尔硫组和美托洛尔组。分别于用药前、用药6个月后记录24h动态心电图(Holter),进行心率变异(HRV)分析,并同时统计各阶段恶性室性心律失常(MVA)的发生率。结果地尔硫、美托洛尔治疗后老年陈旧性心肌梗死患者HRV明显改善。24h正常R R间期标准差(SDNN)、24h内5min节段平均正常心动周期标准差(SDANN)、相邻正常心动周期差值均数的标准差(RMSSD)、相邻正常R R间期差值>50ms的百分比(PNN50%)升高,极低频率(VLF)、低频(LF)、低频与高频的比值(LF/HF)降低。MVA事件发生率较治疗前明显减少。地尔硫组HRV和MVA与美托洛尔组比较差异无显著性意义。结论地尔硫与美托洛尔均可改善老年陈旧性心肌梗死患者HRV,降低MVA发生率,且作用相似。

Objective To observe the effects of diltiazem and metoprolo on heart rate variability （HRV） of the aged patients with remote myocardial infarction and assess their protective action on the cardial muscles. Methods Ninety-two aged patients with remote myocardial infarction were divided into diltiazem group and metoprolo group, subject to the administration of dihiazem or metoprolo respectively. Before and 6 months after treatment, 24h holter data were collected to analyze HRV, and the incidence of malignant ventricular arrhythmia （MVA） was statistically studied at different periods. Results After treatment by dihiazem or metoprolo, HRV was obviously improved in the aged patients with remote myocardial infarction. Standard deviation of normal R-R intervals （SDNN）, standard deviation of the average NN interval （SDANN）, mean square of the successive R-R intervals （RMSSD） and PNN50% were increased, while very low frequency （VLF）, low frequency （LF） and the ratio of LF/HF were decreased. The incidence of MVA events was reduced as compared with that before treatment. There was no significant difference in HRV and MVA between diltiazem and metoprolo groups. Conclusion Both diltiazem and metoprolo can improve HRV and decrease the incidence of MVA in the aged patients with remote myocardial infarction with the similar effects.