摘要
目的探讨两种剂型美托洛尔对冠心病不稳定型心绞痛患者心率变异性(HRV)及QT离散度(QTd)的影响并观察两种剂型美托洛尔对不稳定型心绞痛患者的临床疗效。方法选择2010年6月—2011年6月收入院的100例冠心病不稳定型心绞痛患者为研究对象,随机分为平片组及缓释片组,在常规冠心病治疗基础上,分别服用美托洛尔平片(25.00 mg,2次/d)和缓释片(23.75 mg,1次/d),治疗6个月。观察治疗前和治疗14 d后HRV及QTd的情况;观察治疗6个月时两种剂型美托洛尔治疗不稳定型心绞痛患者的临床疗效。结果治疗14 d后,两组患者24h正常R-R间期标准差(SDNN)、24 h内每5 min平均正常R-R间期值的标准差(SDANN)、相邻正常R-R间期差值的均方根(RMSSD)及相邻正常R-R间期差值≥50 ms的心搏数占总R-R间期数的百分数(PNN50)较治疗前提高,差异有统计学意义(P<0.05);两组治疗14 d后以上指标间差异有统计学意义(P<0.05)。治疗14 d后,两组患者QTd、校正的QT离散度(QTcd)均较治疗前缩短,差异有统计学意义(P<0.05);两组治疗14 d后比较,差异均有统计学意义(P<0.05)。治疗6个月时平片组有3例、缓释组有5例停止服药或改服其他药物;平片组显效15例,有效23例,无效9例,缓释片组显效18例,有效20例,无效7例,两组疗效间差异有统计学意义(u=0.807,P>0.05)。结论应用美托洛尔缓释片治疗不稳定型心绞痛在控制HRV及QTd方面的效果较美托洛尔平片更好,美托洛尔平片和美托洛尔缓释片均能改善不稳定型心绞痛患者预后。
Objective To investigate the clinical efficacy of 2 forms of metoprolol on heart rate variability(HRV) and QT dispersion in coronary heart disease(CHD)patients with unstable angina(USA).Methods A total of 100 USA patients from June 2010 to June 2011 were divided randomly into groups common tablet(CT group) and sustained release tablet(SR group).Based on conventional treatment,CT group were given metoprolol tablets,25.00 mg,2 times/d,SR group given sustained release tablets,23.75 mg,1 time/d,6 months.HRV and QT dispersion were observed before treatment and after 12 d of treatment,the clinical effects of 2 forms on USA evaluated after 6 months of treatment.Results As compared with pre-treatment,24 h mean R-R interval standard deviation(SDNN),every-5-minute mean normal R-R interval standard deviations within 24 h(SDANN),mean square of continuous normal R-R interval values(RMSSD) and the percentage of adjacent normal R-R interval ≥50 ms in total R-R interval(PNN50) improved after 14 d of treatment,the difference was significant(P<0.05).There was difference in the above indicators between 2 groups after 14 d of treatment(P<0.05);QT dispersion,QTcd shorter than pre-treatment,the difference was significant(P<0.05);There was difference between post-treatments in 2 groups(P<0.05).In months 6,3 patients in CT group and 5 in SR group stopped taking their drugs or changed to others;15 patients had remarkable effect,23 had effect,9 had no effect in CT group;18,20,7,respectively,in SR group,the difference was significant(u=0.807,P>0.05).Conclusion Metoprolol sustained release tablets have better effect than common tablets in controlling HRV and QT dispersion in treatment of USA.Both metoprolol tables and metoprolol succinate release tables can improve USA prognosis.
出处
《中国全科医学》
CAS
CSCD
北大核心
2013年第8期870-872,共3页
Chinese General Practice
