美托洛尔对OMI患者心率变异性的影响及对心律失常的治疗作用

Effects of Metoprolol on Heart Rate Variability and Ventricular Arrhythmia in Patients with Old Myocardial Infarction

目的探讨β受体阻滞剂对陈旧性心肌梗塞 (OMI)患者心率变异性 (HRV)的影响及对心律失常的治疗作用。方法采用动态心电图技术对应用常规疗法加美托洛尔治疗的 45例 OMI患者及应用常规疗法治疗的 45例OMI患者进行多项 HRV长程时域指标观察及心肌缺血、心律失常情况观察。结果与对照组比较 ,美托洛尔治疗组治疗后 HRV异常、心肌缺血明显改善 ,心律失常明显减少。其中两组 SDNN分别为 12 2 .36 ms与 99.96 m s,P<0 .0 1。缺血次数分别为 2 1.5次 / 2 4h与 2 5 .2次 / 2 4h,P<0 .0 5。缺血总负荷分别为 386 .6 mm.min/ 2 4h与 95 8mm.min/ 2 4h,P<0 .0 1。室性早搏次数分别为 973次 / 2 4h与 2 2 5 3次 / 2 4h,P<0 .0 1。结论 β受体阻滞剂可以明显改善 OMI患者的 HRV异常 。

Objective To explore the effect of Metoprolol, a β adrenoreceptor block, on heart rate variability(HRV)and ventricular arrhythmia in patients with old myocardial infarction(OMI).Methods Forty five cases with OMI were treated with Metoprolol and compared with control subjects by 24 hour ambulatory ECG.Results SDNN,SDANN,SDNN index and RMSSD were 22.4 ms( P <0.01),15.6 ms ( P <0.01),16.2 ms( P <0.01) and 6.1 ms ( P <0.05)higher respectively in case group than that in control group. Total ischemic burden was 572 mm·min/24h lower and the number of premature ventricular beats within 24 hours was 1 280 lower in case group than that in control group ( P <0.01).Conclusion Metoprolol can significantly improve impaired HRV and reduce the myocardial ischemic burden as well as other cardiac events.