摘要
目的:探讨急性脑梗塞后心脏自主神经功能昼夜节律的变化以及β-受体阻滞剂对其的影响。方法:共入选54例急性脑梗塞患者,将其随机分为两组,组Ⅰ给予常规神经科治疗;组Ⅱ同时加用美托洛尔25mg,bid。另设相同例数的组Ⅲ为健康对照组。比较治疗前以及治疗两周后两组患者心率变异指标(HF,LF,及LF/HF比值)近日节律分布的变化。应用余弦方程拟和法及零振幅检验法进行统计学处理。结果:急性脑梗塞后患者心率变异性明显减低,时间生物学特征也显著改变(振幅减小,相位滞后)。经过两周治疗后,组Ⅰ的心率变异性指标有所恢复,但其昼夜节律仍明显异常;组Ⅱ除心率变异指标的绝对值有明显恢复外,其曲线走性特征也迅速改善。结论:急性脑梗塞后心脏自主神经功能受到明显影响,其近日节律显著异常;β-受体阻滞剂治疗可加快自主神经功能时间生物学指标的改善,对心脏起到有效的保护作用。
Objective: To evaluate the changes in circadian patterns of autonomic nervous system in patients with acute cerebral infarction, 54 such cases were included in this study. Methods: These patients were randomized into two groups with 27 in each group: group Ⅰ patients were administrated routine neurological treatment, and patients in group Ⅱ were given metoprolol (25mg, bid) beyond the routine schedule. Normal subjects (27 cases, group Ⅲ ) were used as controls. 24 - hour Holter monitoring and heart rate variability was performed before and 2 weeks after treatment, with HF, LF, and LF/ HF ratio as main indices. Cosinor - fitting analysis by least square and zero amplitude test were introduced in the statistical processing. Results: It was found that, heart rate variability was lowed significantly after cerebral infarction, and further more, the chronobiological feature of the research indices changed at a greater extent with lowed amplitudes and delayed phases. After 2 weeks treatment, heart rate variability values in both groups were improved, the chronobiological indices were still abnormal in group I but improved significantly in group Ⅱ . Conclusion: It is concluded that, autonomic nervous function as well as its circadian rhythm were damaged significantly after acute cerebral infarction; treated with metoprolol is beneficial to the correction of abnormal autonomic nervous diurnal rhythms and further more, protect the heart from some malignant events probably.
出处
《中国医药导刊》
2002年第3期180-183,共4页
Chinese Journal of Medicinal Guide
基金
河北省科委资助课题(课题编号:98276188D
与992761171)
