氯沙坦联合叶酸对合并H型高血压的急性脑梗死患者心率变异性影响

Effect of Losartan Combined Folic Acid on Heart Rate Variability in H-type Hypertension Patients Complicated with Acute Cerebral Infarction

目的探讨氯沙坦联合叶酸对H型高血压合并急性脑梗死患者心率变异性的影响。方法连续性纳入自2016年3月~2017年3月笔者医院所收治的H型高血压合并急性脑梗死的患者56例,随机分为研究组和对照组,每组各28例。研究组给予氯沙坦钾片50mg/d以及叶酸片0.8mg/d口服;对照组给予单独氯沙坦钾片50mg/d口服。比较两组患者治疗后心率变异性及血清同型半胱氨酸水平改变。结果相比于对照组,研究组治疗后收缩压下降幅度更大(t=2.878,P=0.006),舒张压两组比较差异无统计学意义(P>0.05)。治疗后研究组患者心率变异性时域值正常窦性RR间期(SDNN)显著升高(t=2.267,P=0.027);RR间期平均值标准差(SDANN)显著升高(t=2.106,P=0.039);相邻RR间期差值的均方根(RMSSD)显著升高(t=2.192,P=0.032);相邻NN之差>50ms的个数占总窦性心搏个数的百分比(PNN50)显著升高(t=2.889,P=0.006);频域值低频功率(LF)显著增高(t=2.024,P=0.048);高频功率(HF)显著升高(t=2.365,P=0.022);LF/HF显著下降(t=2.195,P=0.033)。治疗后研究组血清同型半胱氨酸水平较前明显下降(t=4.958,P=0.000),且显著低于对照组(t=4.710,P=0.000)。结论氯沙坦联合叶酸可以有效改善H型高血压合并急性脑梗死患者心率变异性。

Objective To investigate the effect of losartan combined folic acid on heart rate variability in H-type hypertension patients complicated with acute cerebral infarction.Methods Fifty six cases of H-type hypertension complicated with acute cerebral infarction patients admitted to our hospital were collected from March 2016 to March 2017,and were randomly divided into the study group and the control group,each with 28 cases.The research team were treated with losartan tablet 50 mg/d and folic acid tablet 0.8 mg/d;and the control group were treated with osartan tablet 50 mg/d alone.The changes of heart rate variability and serum homocysteine levels were compared between two groups.Results When compared with the control group,the systolic blood pressure reduced more（t = 2.878,P = 0.006） in the study group,but there was no statistical significance in diastolic blood pressure（P 〉0.05）.After treatment,the SDNN significantly increased（t = 2.267,P = 0.027）,SDANN significantly increased（t = 2.106,P = 0.039）;RMSSD significantly increased（t = 2.192,P = 0.032）,PNN50 significantly increased（t = 2.889,P = 0.006）.LF significantly increased（t = 2.024,P =0.048）,HF significantly increased（t = 2.365,P = 0.022）,LF/HF significantly decreased（t = 2.195,P = 0.033） in the study group.The serum homocysteine level of study group was significantly decreased（t = 4.958,P = 0.000） after treatment,and significantly lower than the control group（t = 4.710,P = 0.000）.Conclusion The combination of losartan and folic acid can effectively improve the heart rate variability in H-type hypertension patients complicated with acute cerebral infarction.