血管紧张素转化酶抑制剂对心力衰竭患者自主神经昼夜节律的影响

Effects of angiotension converting enzyme inhibitor on circardian variations of autonomic nervous activity in chronic heart failure

目的:评价血管紧张素转化酶抑制剂(ACEI)对慢性心力衰竭(CHF)患者自主神经昼夜节律的影响。方法:将43例确诊的CHF患者随机分为2组,对照组接受地高辛加利尿剂的基线治疗,治疗组在基线治疗的基础上加用ACEI,6个月后,进行24h动态心电图检测及心率变异性分析。结果:与对照组相比,治疗组心率变异性各项指标在疗程末均有显著性提高。结论:ACEI显著改善CHF患者的自主神经活性及自主性平衡,在日间时段尤为明显。

Objective： To evaluate the circardian effects of ACEI comprehensively on autonomic nervous activity in chronic heart failure （CHF）. Method：Forty nine patients with New York Heart Association class Ⅱ to Ⅳ CHF were divided into two groups randomly： the control group only received baseline therapy of degoxin and diuretics for 6 months, while the treatment group received ACEI（perindopril 4 mg/d） in addition to the baseline therapy. After the treatment phase,an assessment of ACEI＇s effects on circardian variations of autonomic nervous activity was undertaken by means of continuous Hoher recordings and heart rate variability （HRV） analysis. Resnlt：HRV parameters were improved significantly in the treatment group compared with the control group. Conclusion： ACEI had favorable autonomic effects, which were particularly prominent during the daytime.