不同剂量比索洛尔对急性心肌梗死患者心电生理指标的影响

Influence of different doses of bisoprolol on cardiac electrophysiological indicators among patients with acute myocardial infarction

目的研究不同剂量比索洛尔对急性心肌梗死(AMI)患者心电生理指标的影响。方法该研究共纳入89例急性心肌梗死患者,并正规治疗2个月。根据比索洛尔用量将患者随机分为小剂量组(1.25 mg,qd,n=53)和大剂量组(10 mg,qd,n=36)。治疗前后所有患者均接受长程心电图检查。记录相应的心电生理指标:QT、JT离散度、心率变异性的时域、频域指标。所有患者均随访半年。结果治疗2个月后,2组患者QT、JT离散度、心率变异性的时域及频域指标较治疗前均明显改善,但大剂量组更为明显(P<0.05)。2组患者半年内不良心血管事件发生率差异无统计学意义(P>0.05)。结论与小剂量相比,大剂量比索洛尔能进一步减小急性心肌梗死患者QT、JT离散度及提高慢性心率变异性,但并不降低半年内不良心血管事件发生率。

[ Objective] To study the influence of different doses of bisoprolol on ardiac electrophysiological indicators among patients with acute myocardial infarction （AMI}. [Methods] 89 AMI patients were enrolled in this study and were treated for 2 months. According to the dose of bisoprolol, they were randomly divided into low-dose group （1.25 rag, qd, n = 53） and high-dose group （10 mg, qd, n = 36）. Before and after treatment, all patients received long-distance ECG examination. The cardiac electrophysio- logical indicators, like QT, JT dispersion, time domain and frequency domain of heart rate variability （HRV） were recorded, All patients were followed up half year. [ Results ] After two months of treatment, compared to the before, the QT, JT dispersion, time domain and frequency domain of HRV of all patients were improved, and the high-dose group was more obvious （ P 〈 0.05 ）. There was not significant difference in the incidence of adverse cardiovascular event between the two groups （P 〉0.05）. [ Conclusion] Compared with the low-dose bisoprolol, the high-dose bisoprolol is better in decreasing the QT, JT dispersion and improving HRV in AMI patients, but can not reduce the incidence of adverse cardiovascular event.