美托洛尔对冠心病心绞痛患者心率变异性的影响

Effect of metoprolol on heart rate variability in patients with coronary heart disease and angina pectoris

目的分析美托洛尔对冠心病心绞痛患者心率变异性的影响。方法回顾性选取2020年1月至2021年1月本院收治的98例冠心病心绞痛患者作为研究对象,依据治疗方法将其分为常规治疗组和美托洛尔组,各49例。常规治疗组依据患者的实际病情给予个体化心内科西药治疗,美托洛尔组在常规治疗组基础上给予美托洛尔治疗。比较两组的心绞痛发作次数、心率、血压(收缩压、舒张压)、心率变异性时域分析指标(SDNN、SDANN、RMSSD、PNN50)、血清ET-1、NO、cTnI水平及不良反应发生情况。结果治疗后,两组的心绞痛发作次数、心率、收缩压、舒张压均低于治疗前,且美托洛尔组低于常规治疗组(P<0.05)。治疗后,两组的SDNN、SDANN、RMSSD、PNN50均高于治疗前,且美托洛尔组高于常规治疗组(P<0.05)。治疗后,两组的血清ET-1、cTnI水平均低于治疗前,血清NO水平均高于治疗前,且美托洛尔组优于常规治疗组(P<0.05)。两组的不良反应总发生率比较,差异无统计学意义(P>0.05)。结论美托洛尔治疗冠心病心绞痛的效果显著,可有效提升患者的心率变异性。

Objective To analyze the effect of metoprolol on heart rate variability in patients with coronary heart disease and angina pectoris.Methods A total of 98 patients with coronary heart disease and angina pectoris treated in our hospital from January 2020 to January 2021 were selected retrospectively.According to the treatment methods,the patients were divided into routine treatment group and metoprolol group,with 49 cases in each group.The routine treatment group was treated with individualized western medicine in the cardiovascular medicine department according to patient's actual condition,and the metoprolol group was treated with metoprolol on the basis of the routine treatment group.The number of angina pectoris attack,heart rate,blood pressure(systolic and diastolic blood pressure),time-domain analysis indexes of heart rate variability(SDNN,SDANN,RMSSD,PNN50),serum ET-1,NO,cTnI levels and occurrence of adverse reactions were compared between the two groups.Results After treatment,the number of angina pectoris attack,heart rate,systolic blood pressure and diastolic blood pressure in the two groups were lower than those before treatment,and those in the metoprolol group were lower than the routine treatment group(P<0.05).After treatment,the SDNN,SDANN,RMSSD and PNN50 of the two groups were higher than those before treatment,and those of the metoprolol group were higher than the routine treatment group(P<0.05).After treatment,the serum ET-1 and cTnI levels of the two groups were lower than those before treatment,the serum NO level was higher than that before treatment,and those in the metoprolol group were better than the routine treatment group(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion Metoprolol is effective in the treatment of coronary heart disease and angina pectoris,and can effectively improve the heart rate variability of patients.