增加心肌梗死患者心脏迷走神经张力的研究  

A study of increasing cardiac vagal tone in patients after acute myocardial infarction

作　　者：王留义[1] 王丽霞[1] 胡建福 贾耀勤[3] 魏建国[1] 李荣堂[4] 赵士超[1] 

机构地区：[1]河南省人民医院心内科,河南郑州450003 [2]范县公疗医院内科,河南范县457500 [3]郑州市第二人民医院心电室,河南郑州450000 [4]新乡医学院基础部,河南新乡453000

出　　处：《河南医学研究》2002年第3期223-226,共4页Henan Medical Research

基　　金：河南省科技攻关项目 (编号 :95 12 0 0 2 19)

摘　　要：目的 :观察小剂量东莨菪碱贴膜、培哚普利和美托乐尔对急性心肌梗死患者 ,卡托普利和培哚普利对陈旧性心肌梗死患者心脏迷走神经张力的影响。方法 :随机安慰剂对照 ,双盲法给药。治疗前后用心电图机和数字化 2 4hHolter记录测定心率变异性时域参数和频域参数。用苯肾上腺素法测定压力反射敏感性。结果 :经皮东莨菪碱治疗明显增加心率变异性时域参数和频域参数及压力反射敏感性。口服培哚普利和美托洛尔可提高急性心肌梗死患者迷走神经张力 ,降低交感神经张力 ,卡托普利和培哚普利可提高陈旧性前壁心肌梗死患者心脏迷走神经张力 ,降低交感神经张力。结论 :小剂量东莨菪碱透皮治疗、口服培哚普利、美托洛尔和卡托普利可显著增加心肌梗死患者心脏迷走神经张力 。Objective: To investigate whether transdermal scopolamine,oral perindopril, metoprolol and captopril, increased cardiac vagal activity in patients with myocardial infarction Methods: Random,double blind,placebo contrast methods were used Measures of heart rate variability(HRV) in patients given drugs or placebo were obtained by electrocardiograph and digital 24 hour Holter recording before and after treatment Baroreflex sensitivity(BRS) was performed using the phenylephrine method Results: Patients of acute myocardial infarction with transdermal scopolamine showed a significant increase in HRV time domain parameters and BRS after treatment( P <0 05) Cardiac vagal tone increasing and sympathetic tone withdrawal were present in patients with acute myocardial infarction after perindopril and metoprolol treatments( P <0 05) Cardiac vagal tone increasing and sympathetic tone withdrawal were present in patients with remote myocardial infarction after perindopril and captopril treatments( P <0 05) Conclusion: Low doses of transdermal scopolamine,oral perindopril, metoprolol and captopril, increased cardiac vagal activity improve autonomic indices in patients with myocardial infarction

关 键 词：心肌梗死 迷走神经 东莨菪碱 培哚普利 美托乐尔 卡托普利 

分 类 号：R542.22[医药卫生—心血管疾病]