美托洛尔对急性心肌梗死心率变异性及恶性心律失常的影响

Influence of metoprolol on heart rate variability and malignant ventricular arrhythmia in acute myocardial infarction

目的 :探讨美托洛尔对急性心肌梗死 (AMI)后心率变异性 (HRV )及恶性心律失常 (MVA )事件的影响。方法 :将 77例分为美托洛尔组 (4 0例 )及对照组 (37例 ) ,美托洛尔组在常规治疗基础上给予美托洛尔 6 .2 5～ 12 .5 m g,bid,以后根据病情渐加量到 2 5～ 5 0 m g,bid;对照组仅常规治疗 ,并分别测定入院后第 1天、第 7天、0 .5年、1年时 48h动态心电图 ,常规进行 HRV分析 ,并同时观察各阶段 MVA发生率。结果 :1周内两组 HRV及MVA变化差异无显著性意义 ,但美托洛尔组 MVA事件有减少趋势 ,0 .5年后美托洛尔组 HRV显著改善 (P <0 .0 1) ,MVA事件发生率显著低于对照组 (P <0 .0 1)。结论 :美托洛尔能有效改善 AMI后患者 HRV,降低 MVA发生率 ,但此种改变在长时间治疗后明显。

Objective:To discover the effect of metoprolol on heart rate variability (HRV) and malignant ventricular arrhythmia (MVA) in acute myocardial infarction.Method:Seventy seven patients were randomly divided into 2 groups:metoprolol group (n=40) and control group (n=37).The metoprolol group were given metoprolol 12.5 ~50 mg twice a day.Then the HRV and MVA events in each period (1 day,7 day,6 month and 1 year) in two groups were measured and compared.Result:The HRV and MVA events were of no significant changes in both groups in a week. After six month, the MVA events were remarkably decreased in metoprolol group (P< 0.01 ). Conclusion:Metoprolol may improve the HRV and reduce the MVA events in acute myocardial infarction.