β-受体阻滞剂早期治疗对急性心肌梗死患者心率变异的影响

The effect of beta-blockers on heart rate variability in acute myocardial infarction patients

目的 研究早期使用β－ 受体阻滞剂对急性心肌梗死患者心率变异的影响。方法 ４４ 例急性心肌梗死患者入院后随机分为β－ 受体阻滞剂治疗组（１８例）和对照组（２６ 例）。治疗组于即刻给予氨酰心安（１２．５～２５ｍ ｇ／天）或美多心安（２５～５０ｍ ｇ／天），余两组治疗相同。入院后１０～１４ 天行２４ 小时动态心电图检查，分析时域指标ＳＮＤＤＳＤＡＮＮ ｒＭＳＳＤＰＮＮ５０、散点图指标ＶＬＩ、ＶＡＩ的变化。用配对ｔ检验进行统计学处理。结果 早期使用小剂量β－ 受体阻滞剂可使急性心肌梗死患者的心率变异的时域指标、散点图指标均有显著增加。进一步研究发现，这种改善作用在前壁与下壁急性心肌梗死之间无显著性差异。结论 对急性心肌梗死患者早期使用β－ 受体阻滞剂可显著改善患者的心率变异，这种作用在前壁心肌梗死与下壁心肌梗死之间无显著性差异。

Objectives To investigate the effect of beta-blockers on heart rate variability in acute myocardial infarction pateints.Methods 44 cases of acute myocardial infarction patients werer randomly divided into beta-blocker group (18 cases)and control group (26 cases) at addmission.Patients in treatment group were given atenolol (12.5～25mg/day) or metoprolol (25～50mg/day) at once.The other treatments were the same between the two groups.10～14 days after admission,24 hours dynamic ECG monitoring were performed using HOLTER STAR (version 3.0) of Landcom Company.Time domain variables such as SDNN SDANN rMSSD PNN50 and scatterplots indexs such as VLI VAI were computed.Paired t test was used for statistical analysis.Results Early use of low dosage of beta-blockers could improve all above variables of heart rate variability in acute myocardial infartion patients.In the treatment group,there were no discrepancy of these variables between anterior and inferior acute myocardial infarction.Conclusion Early use of beta-blockers in acute myocardial infartion patients could improve heart rate variability.This effect have no difference between anterior and inferior acute myocardial infarction.