左西孟旦对急性心力衰竭患者心率变异性的影响

发布时间：2018-09-01 16:42

【摘要】：目的：观察左西孟旦注射液对急性失代偿心力衰竭(Acute decompensated heart failure, ADHF)患者的心率变异性的影响。方法：选择了延边大学附属医院2012年6月～2013年1月之间治疗的急性心力衰竭的患者60例,随机的分成观察组与对照组,各为30例,均行基础抗心衰治疗；观察组在基础抗心衰治疗上持续微泵注射左西孟旦注射液,疗程为一周,在治疗前后均行常规、生化、心脏彩超及动态超声心动图检查,并记录各项检查结果,通过系统分析得出心功能心率变异性(Heart rate variability HRV)的时域、频域分析指标,比较对照组与观察组治疗前后自主神经功能及心脏功能的改善情况。结果： (1).其中观察组与对照组,它们在患者的年龄、性别、基础心脏病及心功能分级等资料比较上,均差异无统计学意义(P0.05)； (2).观察组与对照组用药前后HRV各参数与治疗前比较,对照组治疗后心率(Heart rate, HR)明显降低(P0.05),24h内正常的RR间期标准差(SDNN)、RR间期平均值的标准差(SDANN)、相邻RR间期差值均方根(RMSSD)、相邻RR间期差值大于50ms百分比(PNN50)、RR间期的标准差的平均值(SDNNI)、低频功率(LF)、高频功率(HF)均升高,其中LF、HF升高具有统计学意义(P0.05);观察组在治疗后,其中HR明显降低(P0.05),SDNN、SDANN、RMSSD、SDNNI、LF、HF均明显升高(P0.05)。对照组与观察组治疗后HR、SDNN、SDANN、RMSSD、SDNNI、LF、HF的参数比较,差异均具有统计学意义(P0.05)。 (3).观察组和对照组在治疗前心功能射血分数及每搏输出量比较,无统计学意义(P0.05),治疗后观察组与对照组均有所改善,观察组改善更加显著,(P0.05)。(4)两组在治疗前后对患者血常规、血糖、血脂、肝功、肾功等变化无显著差异(P0.05)。结论：左西孟旦对急性心力衰竭有显著的治疗作用,改善心率变异性是其机制之一。
[Abstract]:Aim: to observe the effect of levosimendan injection on heart rate variability in patients with acute decompensated heart failure (Acute decompensated heart failure, ADHF). Methods: sixty patients with acute heart failure treated in Yanbian University affiliated Hospital from June 2012 to January 2013 were randomly divided into observation group and control group, 30 cases in each group. All patients were treated with basic anti-heart failure therapy. The observation group received continuous micropump injection of levosimendan injection on basic anti-heart failure therapy for a course of one week. Routine, biochemical, cardiac color Doppler and dynamic echocardiography were performed before and after treatment, and the results were recorded. The time-domain and frequency-domain indexes of heart rate variability (Heart rate variability HRV) were obtained by systematic analysis, and the improvement of autonomic nerve function and cardiac function before and after treatment were compared between the control group and the observation group. Results: (1). There was no significant difference between the observation group and the control group in age, sex, basic heart disease and cardiac function grading (P0.05); (2). The parameters of HRV before and after treatment in the observation group and the control group were compared with those in the control group before and after treatment. Heart rate (Heart rate, HR) decreased significantly after treatment in the control group (P0.05) within 24 hours, the normal RR interval standard deviation (SDNN) / RR interval) standard deviation (SDANN), adjacent RR interval difference value (RMS) (RMSSD), adjacent RR interval difference was greater than 50ms percentage (PNN50) / RR interval standard deviation. The mean (SDNNI), low frequency power (LF), high frequency power (HF) all increased. The increase of LF,HF was statistically significant (P0.05); in the observation group, HR was significantly decreased (P0.05). The parameters of HR,SDNN,SDANN,RMSSD,SDNNI,LF,HF in control group and observation group were significantly different after treatment (P0.05). (3). There was no significant difference in ejection fraction and stroke output before treatment between the observation group and the control group (P0.05). After treatment, both the observation group and the control group improved, and the improvement in the observation group was more significant (P0.05). (4). There was no significant difference in blood lipid, liver function and renal function (P0.05). Conclusion: levosimendan has a significant therapeutic effect on acute heart failure, and improving heart rate variability is one of its mechanisms.
【学位授予单位】：延边大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R541.6

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