丹参酮ⅡA磺酸钠对急性心梗再灌注治疗患者室性心律失常的作用及机制  

Effect and mechanism of sodium tanshinone ⅡA sulfonate on ventricular arrhythmias in acute myocardial infarction patients with reperfusion therapy

作　　者：高兰[1] 孙海燕[1] 王真 孟晓武[1] 蒋芳[1] 杜振兰[1] GAO Lan;SUN Hai-yan;WANG Zhen;MENG Xiao-Wu;JIANG Fang;DU Zhen-lan(Taian City Central Hospital,Taian 271000,China;Taian City Hospital of Traditional Chinese Medicine,Taian 271000,China)

机构地区：[1]泰安市中心医院心功能科,山东泰安271000 [2]泰安市中医医院,山东泰安271000

出　　处：《泰山医学院学报》2020年第9期667-670,共4页Journal of Taishan Medical College

摘　　要：目的探讨丹参酮ⅡA磺酸钠(sodium tanshinone ⅡA sulfonate,STS)对急性心肌梗死再灌注治疗患者室性心律失常及心率变异性(heart rate variability,HRV)、QT离散度(QT dispersion,QTd)、左室射血分数(left ventricular ejection fraction,LVEF)的影响,评价应用STS的有效性。方法收集在我院心内科行再灌注治疗的急性心肌梗死患者80例,分为STS组和对照组两组。每组患者入院及2周时做动态心电图(Holter)检查测定室性心律失常的发生率及数量、HRV、QTd,并应用超声心动图仪测定患者心脏功能。结果 STS组室性心律失常的发生率及数量较对照组减少,STS组患者心率变异性各参数高于对照组,STS组患者QTd低于对照组,STS组患者LVEF相较于对照组升高,差异均有统计学意义(P<0.05)。结论急性心肌梗死患者再灌注治疗的同时静脉应用STS,可以减少室性心律失常的发生率;STS减少室性心律失常的机制可能与改善患者HRV、QTd及LVEF有关;HRV、QTd及LVEF可以作为良好的非侵入性临床指标,为急性心肌梗死再灌注治疗患者室性心律失常的评估提供一种有效的手段。Objective: To explore the effect of sodium tanshinone ⅡA sulfonate(STS) on ventricular arrhythmia and QT dispersion(QTd), heart rate variability(HRV), left ventricular ejection fraction(LVEF) in patients with acute myocardial infarction and reperfusion, and to evaluate the effectiveness of the application of STS.Methods: Eighty cases of patients with acute myocardial infarction for the treatment with reperfusion were collected in our Hospital, and the patients were divided into STS group and control group in the two groups. Holter examination was performed at admission and 2 weeks in each group,in order to determine the incidence, quantity of ventricular arrhythmia, HRV and QTd,and cardiac function in patients were detected with the application of with ultrasound cardiograph.Results: In the STS group, the incidence of ventricular arrhythmias and number were less than those in the control group, STS group of patients were higher in heart rate variability parameters than the control group, STS group were lower in QTd than the control group, LVEF in STS patients was higher compared with the control group, and the difference was statistically significant(P<0.05).Conclusion: In patients with acute myocardial infarction, reperfusion therapy and intravenous STS can reduce the incidence of ventricular arrhythmia.The mechanism of STS in reducing ventricular arrhythmia may be related to the improvement of HRV, QTd and LVEF.HRV, QTd and LVEF can be used as good non invasive clinical index, which provides an effective means for the assessment of reperfusion therapy for acute myocardial infarction in patients with ventricular arrhythmia.

关 键 词：丹参酮ⅡA磺酸钠 急性心肌梗死 心率变异性 QT离散度 左室射血分数 

分 类 号：R541.4[医药卫生—心血管疾病]