非诺贝特对老年急性冠脉综合征患者血浆脑钠肽及心率变异性的影响  

Influence of fenofibrate on plasma BNP level and heart rate variability in aged patients with acute coronary syndrome

作　　者：程永生[1] 蒋华龙[1] 

机构地区：[1]四川省安岳县人民医院急诊科,四川安岳642350

出　　处：《心血管康复医学杂志》2015年第5期536-539,共4页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:探讨非诺贝特对老年急性冠脉综合征(ACS)患者血浆脑钠肽(BNP)及心率变异性(HRV)的影响。方法:选择我院的ACS老年患者150例,随机分成常规治疗组和非诺贝特组(常规治疗联合非诺贝特治疗),各75例。对比治疗前后患者血浆BNP水平、HRV参数、血脂水平和胸痛的变化。结果:治疗后,两组BNP,HRV和血脂水平均明显改善(P均<0.01);与常规治疗组比较,非诺贝特组血浆BNP水平[(132.5±22.1)pg/ml比(91.2±13.7)pg/ml]降低更显著(P<0.01),HRV中正常窦性R-R间期总体标准差(SDNN)、相邻正常R-R间期差值>50ms的百分数(PNN50)、相邻窦性R-R间期差值和均方根值(rMSSD)、高频(HF)水平均显著升高,低频(LF)水平显著下降(P均<0.05),血脂TC、TG、LDL-C水平均显著降低,HDL-C水平显著升高(P均<0.01),治疗后胸痛时间[(9.53±5.34)min比(6.32±2.13)min]与频率[(3.87±1.13)次/d比(2.99±1.14)次/d]均显著降低(P均<0.01)。结论:常规治疗的同时联合非诺贝特治疗老年急性冠脉综合征能显著降低BNP水平、调节血脂并有助于自主神经功能的恢复。Objective： To explore influence of fenofibrate on plasma level of brain natriuretic peptide （BNP） and heart rate variability （HRV） in aged patients with acute coronary syndrome （ACS）. Methods： A total of 150 aged ACS patients undergoing treatment in our hospital were selected, randomly and equally divided into routine treat- ment group and fenofibrate group. Changes of plasma BNP level, HRV parameters, blood lipid levels, and chest pain were compared between two groups before and after treatment. Results： After treatment, BNP level signifi- cantly reduced, and HRV, blood lipid levels significantly improved in both groups, P〈0.01 all. Compared with routine treatment group, plasma BNP level significantly reduced [ （132.5 ± 22. 1） pg/ml vs. （91.2 ± 13.7） pg/ml] （P〈0.01） ; there were significant rise in standard deviation of normal to normal RR intervals calculated over the 24 h period （SDNN）, adjacent normal RR interval difference 〉 50ms stroke accounted for a percentage of 24h total RR interval （PNNS0）, root-mean square of differences between successive normal to normal intervals （rMSSD） and high frequency （HF）, and significant reduction in low frequency （LF）, P〈0.05 all; significant reductions in levels of TC, TG and LDL-C, and significant rise in HDL-C level （P〈0.01 all）; there were significant reductions in on- set duration [ （9.53 ±5.34） min vs. （6.32 ± 2.13） mini and frequency [ （3.87 ± 1.13） times/d vs. （2.99 ± 1.14） times/d] of chest pain after treatment in fenofibrate group, P〈0. 01 both. Conclusion： Routine therapy combined fenofi- brate can significantly reduce BNP level, regulate blood lipid and autonomic nervous function in aged ACS patients.

关 键 词：急性冠状动脉综合征 利钠肽 脑 非诺贝特 

分 类 号：R541.4[医药卫生—心血管疾病]