阿替洛尔对老年冠心病人心率变异性的影响

Effect of atenolol on heart rate variability in elderly patients with coronary heart disease

目的 观察阿替洛尔对老年冠心病人心率变异性（ ＨＲＶ） 的影响，探讨其临床意义。 方法 将８６例老年冠心病人分为阿替洛尔组和对照组。阿替洛尔组在硝酸酯类扩冠药治疗基础上，加服阿替洛尔６－２５ ～１２－５ ｍ ｇ ，每日１ ～２ 次，用２４ｈ Ｈｏｌｔｅｒ 资料对２ 组的ＨＲＶ 进行分析对比。 结果 阿替洛尔组ＨＲＶ 参数中反映交感神经和迷走神经双重活性的ＳＤＮＮ（１２１－９７ ±２６－２０） ｍｓ 、ＳＤＡＮＮ（１０７－７７ ±２５－９０） ｍｓ 、ＳＤＮＮｉｎｄｅｘ（５０－１３ ±１８－０１） ｍｓ 及ＬＦ（３９８－８１ ±２８１－１２） ｍｓ２·Ｈｚ－ １较对照组有显著提高（ Ｐ＜ ０－０５） 。 结论 阿替洛尔对ＨＲＶ 的影响主要是通过改善交感神经与迷走神经的失衡而实现的。

The aim of this study was to observe the influence of atenolol on heart rate variability (HRV)in elderly patients with coronary heart disease(CHD)and discuss its clinical significance. Methods 86 patients aged 60～78 with CHD were divided alternatively into 2 groups:control group,43 cases using nitrates only,and atenolol group,43 cases taking atenolol 6 25～12 5mg qd or bid together with nitrates.HRV were observed by Holters ambulatory ECG in all patients of the 2 groups. Results In the atenolol group,the index of HRV reflecting both the sympathetic and parasympathetic activities as SDNN(121 97±26 20)ms,SDANN(107 77±25 90)ms,SDNN index (50 13±18 01)ms and LF(396 81±281 12)ms 2.Hz -1 are all higher than the control group significantly ( P <0 05).It means the atenolol do influence both sympathetic and parasympathetic activities. Conclusions Hence HRV influenced by atenolol in the elderly patients was performed by improving the imbalance between the sympathetic and parasympathetic activities,use of atenolol in the CHD patients will be beneficial to prevention the malignant arrhythmias.