美托洛尔联合沙库巴曲缬沙坦对高血压合并房颤患者心率变异性及血清BNP、AngII水平的影响  

Effects of metoprolol combined with sacubitril-valsartan on heart rate variability and levels of serum BNP and AngII in hypertensive patients with atrial fibrillation

作　　者：王辛 王鑫 白跳 黄馨谅 Wang Xin;Wang Xin;Bai Tiao;Huang Xiniang(Department of Cardiovascular Disease,Xi'an No.9 Hospital,Xi'an 710000,China)

机构地区：[1]西安市第九医院心血管病科,西安710000

出　　处：《中国实用医刊》2024年第17期107-110,共4页Chinese Journal of Practical Medicine

基　　金：陕西省自然科学基础研究计划项目(2022JM-580)。

摘　　要：目的探讨美托洛尔联合沙库巴曲缬沙坦对高血压合并房颤患者心率变异性及血清脑利尿钠肽(BNP)、血管紧张素II(AngII)水平的影响。方法队列研究。抽取2021年1月至2013年12月西安市第九医院收治的79例高血压合并房颤患者为研究对象,按照信封法分为研究组(40例)和对照组(39例)。研究组采用美托洛尔联合沙库巴曲缬沙坦治疗,对照组采用美托洛尔联合缬沙坦治疗。记录并比较两组治疗前后心率变异性[正常连续RR间期差值均方根(rMSSD)、正常窦性RR间期的总体标准差(SDNN)、每5 min正常RR间期均值标准差(SDANN)、高频率段(HF)、低频率段(LF)]及实验室指标(BNP、AngII)。结果治疗前,两组rMSSD、SDNN、SDANN、HF、LF水平比较差异未见统计学意义(P>0.05);治疗后,研究组rMSSD、SDNN、SDANN、HF水平高于对照组,LF水平低于对照组(P<0.05)。治疗前,两组BNP、AngII水平比较差异未见统计学意义(P>0.05);治疗后,研究组BNP、AngII水平低于对照组(P<0.05)。结论应用美托洛尔联合沙库巴曲缬沙坦治疗高血压合并房颤患者效果显著。Objective To investigate the effects of metoprolol combined with sacubitril-valsartan on heart rate variability and levels of serum brain natriuretic peptide(BNP)and angiotensin II(AngII)in patients with hypertension complicated by atrial fibrillation.Methods:Seventy-nine patients with hypertension complicated by atrial fibrillation admitted to Xi’an No.9 Hospital from January 2021 to December 2013 were selected as the research subjects of the cohort study.And they were divided into a study group(40 cases)and a control group(39 cases)using envelope method.The study group was treated with metoprolol combined with sacubitril-valsartan,while the control group was treated with metoprolol combined with valsartan.The heart rate variability evaluated by the root mean square of successive differences between normal-to-normal RR intervals(rMSSD),standard deviation of all normal-to-normal NN intervals(SDNN),the standard deviation of average 5-minute normal-to-normal intervals(SDANN),high frequency(HF)and low frequency(LF)before and after treatment was recorded and compared between the two groups.The preoperative and postoperative laboratory indicators(BNP,AngII)of the two groups were recorded and compared.Results Before treatment,there was no statistically significant difference in the levels of rMSSD,SDNN,SDANN,HF and LF between the two groups(P>0.05).After treatment,the levels of rMSSD,SDNN,SDANN and HF in the study group were higher than those in the control group,while the level of LF was lower than that in the control group(P<0.05).Before treatment,there was no statistically significant difference in the levels of BNP and AngII between the two groups(P>0.05).After treatment,the levels of BNP and AngII in the study group were lower than those in the control group(P<0.05).Conclusions Metoprolol combined with sacubitril-valsartan has a significant therapeutic effect on hypertension complicated by atrial fibrillation.

关 键 词：高血压 房颤 美托洛尔 沙库巴曲缬沙坦 心率变异性 脑利尿钠肽 血管紧张素II 

分 类 号：R544.1[医药卫生—心血管疾病] R541.75[医药卫生—内科学]