新活素对老年急性心肌梗死患者心率变异性及内皮功能影响

Effects of lyophilized recombinant human brain natriuretic peptide on heart rate variability and endothelial function in elder acute myocardial infarction patients

目的探讨新活素对老年急性心肌梗死(AMI)患者心率变异性(HRV)及内皮功能影响。方法入选年龄>60岁的104例AMI患者分为治疗组和对照组,每组各52例。对照组患者采用常规治疗,治疗组在上述基础上加用新活素。对比两组患者治疗前后的肱动脉内皮依赖性舒张功能(FMD)及血清一氧化氮(NO)及内皮素1的含量变化。比较两组患者各项时域及频域指标的变化情况。结果经过治疗后,治疗组的FMD、血清NO含量较对照组明显提高,内皮素1含量较对照组下降,差异具有统计学意义(P<0.05);治疗组的时域指标(SDNN、SDANN、RMSSD)及频域指标(LF和HF)较对照组均有明显改善,差异具有统计学意义(P<0.05)。结论新活素可以有效地改善老年心肌梗死患者心率变异性以及血管内皮功能,改善心肌供血,患者心功能不全的发生率低。

Objective To explore the effects of lyophilized recombinant human brain natriuretic peptide （Lrh-BNP） on heart rate variability （HRV） and endothelial function in elder acute myocardial infarction （AMI） patients.Methods 104 AMI patients over 60 years old were divided into study group and control group, each group contains52 patients. Patients in control group were treated with conventional drugs and patients in study group were treatedwith conventional drugs plus intravenous Lrh-BNP injection. Nitric oxide （NO） and endothelin-1 （ET-1） and brachialarterial endothelium-dependent diastolic function were detected. The time domain and frequency domain wereanalyzed in study group and control group. Results The brachial arterial endothelium-dependent diastolic functionwas significantly better in study group than in control group after treatment. The serum NO level was significantlyhigher while the serum ET-1 level was significantly lower in study group than in control group （P〈0.05）. After treatedwith Lrh-BNP,HRV and time-domain analysis in study group revealed a significant improvement in SDNN、SDANN、RMSSD （P〈0.05）. Frequency domain （LF and HF） were also improved （P〈0.05）. Conclusion Lrh-BNP canimprove endothelial function and the declined HRV in a dramatic way, and can also decrease the incidence of cardiacinsufficiency.