阿托伐他汀钙对陈旧性心肌梗死患者植物神经功能的影响

The effect of atorvastatin calcium to autonomic nervous function of patient with old myocardial infarction

目的观察阿托伐他汀钙对陈旧性心肌梗死(OMI)患者心脏植物神经功能的影响。方法选择OMI患者50例随机分为试验组和对照组,每组25例。对照组行常规OMI治疗;试验组在对照组基础上加用阿托伐他汀钙20mg/d。治疗4周后,进行心率变异分析及尿儿茶酚胺测定。结果试验组OMI患者心率变异性指标参数中24h R-R间期的标准差(SDNN)、低频段面积(LF)和高频段面积(HF)均比治疗前明显增加,LF/HF值比治疗前明显降低,差异均有统计学意义(P<0.05);且试验组治疗后SDNN、LF及HF水平高于对照组,LH/HF值低于对照组,差异均有统计学意义(P<0.05)。试验组治疗后尿去甲肾上腺素含量和多巴胺含量明显低于治疗前(P<0.05),且低于对照组(P<0.05)。结论阿托伐他汀钙对OMI患者具有降低交感神经活性、引起迷走神经张力增加、改善患者心脏植物神经系统的功能。

Objective To evaluate the effect of atorvastatin calcium on autonomic nervous function of patient with old myocardial infarction（OMI）.Methods 50 cases patients with OMI were randomly divided into experimental group and control group,each of 25 cases.Control group were given conventional treatment of OMI;And on the base of control group,experimental group were given atorvastatin calcium 20mg/d.Four weeks after treatment,analysed the heart rate variability and determined the urinary catecholamine.Results The heart rate variability index parameter 24h R-R interval standard deviation（SDNN）,low frequency area（LF） and high frequency area（HF） of experimental group were significantly higher than those before treatment,LF/HF ratio value significantly reduced,the difference were statistically significant（P0.05）;And after treatment,SDNN,LF and HF level of experimental group were higher than those of control group,LH/HF value was lower than that of control group,the difference were statistically significant（P0.05）.After treatment urinary norepinephrine and dopamine levels of experimental group were significantly lower than before treatment（P0.05）,and lower than those of control group（P0.05）.Conclusion Atorvastatin calcium can reduce sympathetic activity,increase the tension vagus nerve and improve cardiac autonomic nervous system function in patient with OMI.