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探讨β受体阻滞剂心得安是否可以改善短效钙拮抗剂心痛定的心率变异性(HRV)。将101例观察对象随机分为对照组(只使用心痛定,n=49)和试验组(使用心痛定和心得安,n=52),分别在服药前及服药后7～10天做24h动态心电图检测,分析HRV指标:正常RR间期的标准差(SDNN)、每5min平均RR间期的标准差(SDANN)、相邻RR之差的均方根(RMSSD)、相邻RR之差>50ms占总窦性心搏的百分数(PNN50)、低频(LF)、高频(HF)、低频和高频比值(LF/HF)。结果:对照组在治疗后心率(HR)加快,SDNN、SDANN显著降低(分别为105.2±31.8msvs126.9±32.0ms、98.9±20.1msvs107.9±19.8ms,P均<0.05),LF、LF/HF升高(分别229.3±77.1Hzvs196.1±64.8Hz、5.4±1.9vs3.8±1.8,P均<0.05),HRV降低;而试验组在治疗后心率无明显改变,SDNN、SDANN、LF、HF升高(分别为140.1±29.8msvs129.1±31.9ms、127.8±21.1msvs108.2±20.1ms、209.8±70.1Hzvs197.3±65.1Hz、148.5±48.8Hzvs123.5±41.0Hz,P均<0.05),LF/HF降低(P<0.05),治疗组HRV升高。结论:心得安能改善短效钙拮抗剂心痛定的HRV。
To investigate whether beta-blocker propranolol can improve heart rate variability (HRV) of short-acting calcium antagonist. 101 subjects were randomly divided into control group (n = 49 with nifedipine only) and experimental group (n = 52 with nifedipine and propranolol), 24h before and after 7 ~ 10 days ECG test, analysis of HRV indicators: standard deviation of normal RR interval (SDNN), every 5min the average RR interval standard deviation (SDANN), the difference between adjacent RRs root mean square (RMSSD), the difference between adjacent RRs> 50ms% of total sinus beats (PNN50), low frequency (LF), high frequency (HF), low frequency and high frequency ratio (LF / HF). Results: The heart rate (HR), SDNN and SDANN of the control group were significantly decreased after treatment (105.2 ± 31.8 ms vs 126.9 ± 32.0 ms, 98.9 ± 20.1 ms vs 107.9 ± 19.8 ms, respectively, P <0.05) / HF (229.3 ± 77.1Hz vs 196.1 ± 64.8Hz, 5.4 ± 1.9vs3.8 ± 1.8, P <0.05 respectively), and HRV decreased; while the experimental group had no significant change in heart rate after treatment, SDNN, SDANN, LF , HF increased (140.1 ± 29.8 ms vs 129.1 ± 31.9 ms, 127.8 ± 21.1 ms vs 108.2 ± 20.1 ms, 209.8 ± 70.1 Hz vs 197.3 ± 65.1 Hz, 148.5 ± 48.8 Hz vs 123.5 ± 41.0 Hz, respectively, P < 0.05), LF / HF decreased (P <0.05), HRV increased in the treatment group. Conclusion: Prednisone improves short-acting calcium antagonist nifedipine HRV.