阿托伐他汀对心肌梗死合并糖尿病患者心率变异性的影响

发布时间：2018-07-08 13:02

本文选题：阿托伐他汀 + 心肌梗死　；参考：《青岛大学》2017年硕士论文

【摘要】：目的观察阿托伐他汀对心肌梗死合并糖尿病患者心率变异性的影响。方法选取2015年6月-2016年6月于我院住院的心肌梗死合并糖尿病患者110例,采用随机数字法分为实验组和对照组,对照组采用常规治疗(酒石酸美托洛尔12.5mg~50mg,bid;硝酸异山梨酯5~10 mg,tid;阿司匹林肠溶片100mg,qn;阿托伐他汀10mg,qn,实验组在常规治疗基础上强化阿托伐他汀治疗(阿托伐他汀40mg,qn)疗程6个月。治疗前后测定心率变异性时域参数SDNN,SDNNI,SDANN;RMSSD;PNN50,和频域参数高频功率(HF)和低频功率(LF),其中以SDNN、RMSSD、SDNNI、SDANN、PNN50代表HRV时域指标,以HF代表迷走神经活性,LF代表交感神经活性.所得实验数据采用SPSS 17.0统计软件进行统计学处理,计量资料以均数±标准差(x±s)表示,两样本均数之间统计学差异t检验,单因素分析用方差分析,然后两两比较再用x2检验,P0.05为差异有统计学意义。比较两组临床效果。结果1.研究对象一般情况比较两组研究对象年龄、性别和BMI差异无统计学意义(P0.05)。两组研究对象常规检测指标差异无统计学意义(P0.05)。2.两组治疗前后血脂比较治疗前两组血脂水平无明显差异,治疗后两组血脂均有所下降,但实验组下降较对照组更显著。3.实验组治疗前后HRV参数比较与治疗前相比,治疗后实验组,时域指标SDNN、SDANN、SDNNI、RMSSD值均明显好转,有统计学意义(P0.05),PNN50值差异不显著(P0.05).其频域指标LF、HF亦有显著差异(P0.05)。4.对照组治疗前后HRV参数比较治疗后HRV指标有一定改善,但其值并无统计学意义(P0.05)。5.两组治疗前后HRV参数比较治疗后实验组与对照组比较,其时域指标SDNN、SDANN、SDNNI、RMSSD值均明显好转,有统计学意义(P0.05),PNN50值差异不显著(P0.05).其频域指标LF、HF亦有显著差异(P0.05)。结论6个月的强化阿托伐他汀治疗可显著改善心肌梗死合并糖尿病患者心率变异性。
[Abstract]:Objective to observe the effect of Atto vastatin on heart rate variability in patients with myocardial infarction and diabetes mellitus. Methods 110 patients with myocardial infarction complicated with diabetes mellitus from June 2015 to June 2016 were randomly divided into experimental group and control group. The control group was treated with routine therapy (metoprolol tartrate 12.5 mg / L 50 mg / g bid; isosorbide nitrate 10 mg / kg tid; aspirin enteric-coated tablet 100 mg / g QN; Atto vastatin 10 mg / g QN). The experimental group was treated with Atto vastatin (40 mg / g QN) for 6 months on the basis of routine treatment. The time domain parameters of heart rate variability (SDNN), SDNNV SDNNIN, RMSSDN PN50, frequency domain parameters HF and low frequency power (LF) were measured before and after treatment. Among them, SDNNV RMSSDN SDNN 50 represented HRV time domain index, HF represented vagus nerve activity and LF represented sympathetic nerve activity. The experimental data were processed by SPSS 17.0 statistical software. The measured data were expressed as mean 卤standard deviation (x 卤s). T test of statistical difference between the two samples and analysis of variance were used in single factor analysis. Then pairwise comparison with X 2 test for the difference was statistically significant. To compare the clinical effect between the two groups. Result 1. There was no significant difference in age, sex and BMI between the two groups (P0.05). There was no significant difference between the two groups (P0.05). There was no significant difference in blood lipid levels between the two groups before and after treatment, but the blood lipid levels in the experimental group were lower than those in the control group, but the decrease in the experimental group was more significant than that in the control group. The parameters of HRV before and after treatment in the experimental group were significantly improved compared with those before and after treatment, and there was no significant difference in the value of PNN50 between the two groups (P0.05). The frequency domain index LFN HF also had significant difference (P0.05). 4. The parameters of HRV in the control group were improved after treatment, but the values were not statistically significant (P0.05). Comparison of HRV parameters before and after treatment between the experimental group and the control group, the time domain index of SDNNN SDANNNNINNIN RMSSD was significantly improved, and there was no significant difference in PN50 between the two groups (P0.05). The frequency domain index LFN HF also had significant difference (P 0.05). Conclusion 6 months intensive Atto vastatin therapy can significantly improve heart rate variability in patients with myocardial infarction and diabetes.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R542.22;R587.1

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