美托洛尔、卡托普利对急性冠脉综合征患者心率变异性的影响

Effects of metoprolol and captopril on heart rate variability in patients with acute coronary syndrome

目的观察美托洛尔、卡托普利对急性冠脉综合征(ACS)患者心率变异性(HRV)的影响。方法所有入选的ACS患者随机分为三组,美托洛尔组(n=19)、卡托普利组(n=15)、对照组(n=18)。测定三组患者用药前及用药30d后的24h心率变异性。结果①治疗前三组患者之间HRV各项观察指标比较的差异均无统计学意义(均P>0.05);②美托洛尔、卡托普利治疗后,HRV各项观察指标较治疗前均有显著提高(均P<0.05)。③治疗后三组患者之间HRV各项观察指标比较,正常RR间期标准差(SDNN)在三组之间的差异有统计学意义(P<0.01),美托洛尔组、卡托普利组与对照组分别为(132·5±21.2)ms,(112.9±22.4)ms,(86.9±22.6)ms。结论美托洛尔和卡托普利可分别改善无并发症的急性冠脉综合征患者的心率变异性,改善失衡的自主神经功能,且美托洛尔改善程度要优于卡托普利。

Objective To observe the effects of metoprolol and captopril on heart rate variability （HRV） in patients with acute coronary syndrome （ACS）. Methods The patients with ACS were randomly divided into 3 groups： metoprolol group （ n = 19）, captopril group （ n = 15） and control group （ n = 18）. Twenty-four hour heart rate variability was examined before medication and 30 days after medication. Results ①There were no significant differences before treatments in HRV time-domain indexes between 3 groups （P〉0.05）. ②In metoprolol group and captopril group, the HRV time-domain indexes were improved significantly after treatment with metoprolol or captopril （P 〈 0.05）. ③There were significant differences of the standard deviation of all normal-tonormal RR intervals （SDNN） in 3 groups after therapy （P 〈 0.01 ）, and SDNN metoprolol group （ 132.5 ± 21.2ms ） 〉 SDNN captopril group （ 112.9 ± 22.4ms） 〉 SDNN control group （86.9 ±22.6ms）. Conclusion Metoprolol and captopril can significantly improve the HRV of patients with uncomplicated acute coronary syndrome, and improve imbalance of the autonomic nervous system of patients. The effect of metoprolol is superior to eaptopril.