美多心安、硝酸异山梨醇酯对心绞痛患者心率变异性影响的比较

Effects of metoprolol and isosorbide dinitrate on heart ratevariabitily in patients with coronary heart disease

目的：探讨美多心安、硝酸异山梨醇酯对心绞痛患者心率变异性（ＨＲＶ）影响的异同。方法：对服用美多心安及服用硝酸异山梨醇酯的心绞痛患者分别在服药前及服药后７ｄ做ＨＲＶ检验并进行比较。结果：服用美多心安７ｄ后连续正常Ｒ－Ｐ间期差值的均方根、低频峰绝对面积（ＬＦ）较服药前有显著性差异（Ｐ＜０．０５），极低频峰绝对面积、中频峰绝对面积及ＬＦ与高频峰绝对面积（ＨＦ）的比值（ＬＦ／ＨＦ）较服药前有极显著性差异（Ｐ＜０．０１）；服用硝酸异山梨醇酯７ｄ后，除ＬＦ／ＨＦ较服药前有显著性差异（Ｐ＜０．０５）外，其他指标无显著变化。结论：两药均可改善心绞痛患者的ＨＲＶ。

Objective: To compare the effects of metoprolol and isosorbide dinitrate (ISD) on heart rate variability (HRV) in patients with angina pectoris. Method: 32 cases with effort angina pectoris were included in this study.They were given metoprolol 50 mg bid for 7 days.30 of them received ISD for another 7 days after 7 day withdrawal of metoprolol.HRV were determined before and after each 7 day medication. Result: After metoprolol was administered for 7 days the rMSSD(root mean square of successive difference in RP intervals, ms),one index in short duration time domain analysis, increased significantly (P<0.05) and four indexes of short duration frequency domain analysis, including VLF(absolute area of very low frequency peak,ms2), LF(absolute area of low frequency peak,ms2), MF(absolute area of middle frequency peak, ms2)and ratio of LF/HF, were all decreased markedly (P<0.05 or 0.01). Also, it is found that after 7 days of isosorbide dinitrate administration the ratio of LF/HF was reduced significantly MetoprololIsosorbide dinitrate(P<0.05). As far as the difference of ratio of LF/HF is concerned, it is more marked in metoprolol than in isosorbide dinitrate (1.11.5 vs. 0.330.78,P<0.05). Conclusion: This shows that these two drugs can help HRV of patients with coronary heart disease to develop toward a beneficial direction, and metoprolol is better.