摘要
目的观察比索洛尔不同给药时间对慢性心力衰竭患者去甲肾上腺素(NE)、肾上腺素和血管紧张素(Ang)水平的影响。方法选择2013年3月—-2016年3月海南省西部中心医院心血管内科诊治的轻中度慢性心力衰竭患者56例作为观察组,于同期医院进行健康体检正常者30例为健康对照组。观察组按服药时间分为2亚组各28例:早晨亚组给予早7~8时服用比索洛尔,晚间亚组给予晚19~20时服用比索洛尔,4周为1疗程。治疗前后分别进行动态心电图检测,并于2时、6时、10时、14时、18时、22时共6个时间点检测血浆去甲肾上腺素、肾上腺素、血管紧张素水平。结果观察组心力衰竭患者在6时、10时、14时、18时、22时、次日2时等各个时间点NE、肾上腺素及血管紧张素均高于健康对照组(F=16.325,P=0.000)。采用Pearson分析后,2组受检者心率与NE、肾上腺素及血管紧张素水平呈正相关性(P均<0.05)。治疗后心力衰竭2亚组患者在各个时间点的NE、肾上腺素及血管紧张素均较治疗前显著降低(P<0.05),但昼夜节律异常均未恢复,且2亚组患者治疗前后差异无统计学意义(t=2.856,P=0.135)。结论慢性心力衰竭患者不同时段服用比索洛尔可降低心率及去甲肾上腺素、肾上腺素和血管紧张素水平,但对昼夜节律无显著影响。
Objective To study the effects of bisoprolol on norepinephrine epinephrine and angiotensin in patients with chronic heart failure. Methods 56 patients with mild to moderate chronic heart failure diagnosed in the hospital from March 2013 to March 2016 were selected as heart failure group and another 30 normal subjects as control group. Heart failure was randomly divided into two subgroups （ n = 28 ）. The first group taking bisoprolol at 7：00 -8： 00, the second group taking bisoprolol at 19：00 - 20：00 ; before treatment and 4 weeks after treatment, respectively, dynamic electrocardiogram, adrenaline and angiotensin II （AngII） were measured at 2：00,6：00,14：00,18：00 and 22：00. Results The NE, epinephrine and an- giotensin in chronic heart failure patients were higher than those in the normal control group at 6： 00,10： 00,14：00,18： 00, 22： 00, and 2： 00（ F = 16. 325, P =0. 000）. Circadian rhythm disappeared after cosine-fit method. The heart rate was posi- tively correlated with NE, epinephrine and angiotensin （ P 〈 0.05 ）. The levels of NE, epinephrine, and angiotensin were sig- nificantly lower in patients with HF than those in the control group （ F = 7. 856, P 〈 0.05 ） at all time points, but the circa- dian rhythm abnormality did not recover. There was no significant difference between before and after treatment （ t = 2. 856, P = 0. 135 ）. Conclusions Chronic heart failure patients with 24-hour heart rate and norepinephrine, epinephrine and angio- tensin II and other factors circadian rhythm abnormalities. Bisoprolol at different time could reduce the heart rate and the lev- els of norepinephrine, epinephrine and angiotensin II in chronic heart failure patients, but had no significant effect on circadian rhythm.
出处
《疑难病杂志》
CAS
2017年第4期336-339,共4页
Chinese Journal of Difficult and Complicated Cases
