比索洛尔治疗室性早搏的疗效及其对心脏自主神经功能的影响

Clinical efficacy of bisoprolol in the treatment of premature ventricular beat and its effect on cardiac autonomic nervous function

目的观察比索洛尔治疗室性早搏的临床疗效,探讨其对室性早搏患者心脏自主神经功能的影响。方法回顾性分析2011年10月至2014年10月我院收治的100例室性早搏患者的临床资料,将采用常规治疗的47例患者纳入常规组,采用比索洛尔治疗的53例患者纳入比索洛尔组。比较两组患者的临床疗效及治疗前后心率、血压及心率变异(HRV)情况。结果比索洛尔组患者的显效率和总有效率分别为66.0%和92.5%,明显高于常规组的27.7%和66.0%,差异均有统计学意义(P<0.05);与常规组治疗后的收缩压、舒张压和心率相比,比索洛尔组下降更加明显,差异均有统计学意义(P<0.05);比索洛尔组治疗后与常规组治疗后在全部窦性心搏RR间期(SDNN)、R-R间期平均值的标准差(SDANN)、R-R间期与平均R-R间期大于50MS的个数占总数的百分比(PNN50)、低频功率对数(In LF)、高频功率对数(In HF)、低频与高频功率比值(In LEF)指标上差异均有统计学意义(P<0.05);在不同室性早搏分级中,Lown分级2级和4级的频域指标SDNN、SDANN、SDNN Index、PNN50比较差异均有统计学意义(P<0.05)。结论比索洛尔对室性早博有明显疗效,对心脏自主神经功能活动有明显改善作用。

Objective To observe the clinical efficacy of bisoprolol in the treatment of premature ventricular beat, and to investigate it＇s effect on cardiac autonomic nervous function of the patients with premature ventricular beat. Methods The clinical data of 100 patients with premature ventricular beat in our hospital from October 2011 to October 2014 were retrospectively analyzed. Forty-seven patients treated with conventional therapy were enrolled as the routine group, and 53 patients receiving bisoprolol were enrolled as the bisoprolol group. The clinical effects, the heart rate, blood pressure and heart rate variability（HRV） before and after treatment were compared between the two groups. Results The markedly effective rate and the total effective rate were 66.0% and 92.5% in the bisoprolol group, significantly higher 27.7% and 66.0% in the routine group. After treatment, the decreases in systoltic pressure,diastolic pressure and heat rate of the bisoprolol group were more significant than those in the routine group（P〈0.05）.The standard deviation of the normal-to-normal intervals（SDNN）, standard deviation of the average normal-to-normal intervals（SDANN）, percentage of differences exceeding 50 ms between adjacent normal number of intervals（PNN50）In LF, In LEF of the bisoprolol group showed statistically significant differences with those of the routine group. For different classification of premature ventricular beats, there were significant differences in SDNN, SDANN, SDNN index, PNN50 between Lown grade 2 and Lown grade 4. Conclusion Bisoprolol has significant curative effect on premature ventricular beats. It has significantly improved the function of cardiac autonomic nerve function.