摘要
目的:探讨参松养心胶囊联合琥珀酸美托洛尔对冠心病(CHD)心律失常患者血流动力学及心率变异(HRV)的影响。方法:选取本院收治的CHD心律失常患者90例为研究对象,随机分为观察组和对照组,2组患者均给予常规强心、降脂、硝酸酯类、利尿剂、血管紧张素转换酶抑制剂、营养心肌、正性肌力等药物治疗,对照组口服琥珀酸美托洛尔缓释片,观察组在对照组基础上口服参松养心胶囊,2组患者均持续治疗4周后进行评价。2组患者治疗前后采集晨起空腹静脉血,采用无创血流动力学检测仪测定血细胞沉降率(ESR)、血细胞比容(HCT)、血浆比黏度(np)、高切变率下全血黏度(nbh)、低切变率下全血黏度(nbl);离心提取血清,采用ELISA法检测血管内皮生长因子(VEGF),散射比浊法测定C反应蛋白(CRP)、脑钠肽(BNP)。治疗前后行24h心电监测,测定早搏数及心率变异(HRV)指标,包括窦性心搏R-R间期标准差(SDNN)、每隔5min窦性心搏R-R间期平均值标准差(SDANN)、相邻窦性心搏R-R间期差值均方根(RMSSD)、每隔5min窦性心搏R-R间期标准差平均值(SDNNI)、相邻窦性心搏R-R间期差值4h大于50ms所占百分比(PNN50)。结果:观察组治疗后ESR、HCT、np、nbh、nbl低于对照组(P<0.05);观察组治疗后CRP、VEGF、BNP低于对照组(P<0.05);观察组治疗后SDNN、SDANN、PNN50高于对照组(P<0.05)。结论:参松养心胶囊联合琥珀酸美托洛尔可有效改善CHD心律失常患者血流动力学,减轻机体炎症反应,改善HRV,提高治疗效果。
Objective:To explore the effect of Shensong Yangxin capsule in combined with metroprolol succinate on the hemodynamics and heart rate variability(HRV)in patients with arrhythmia of coronary heart disease(CHD).Methods:A total of 90 patients with arrhythmia of CHD who were admitted in our hospital from October,2016 to September,2017 were included in the study and randomized into the observation group and the control group.The patients in the two groups were given routine heart strengthening,lipid lowering,nitrates,diuretics,ACEI,myocardial nourishing,and positive inotropic action.The patients in the control group were orally administrated with metroprolol succinate released tablets.On the above basis,the patients in the observation group were given Shensong Yangxin capsule.After a continuous 4-week treatment,the efficacy was evaluated.The morning fasting venous blood before and after treatment was collected and centrifuged for the serum.The noninvasive hemodynamics detector was used to detect ESR,HCT,np,nbh,and nbl.ELISA was used to detect VEGF.The scattering turbidimetry was used to detect CRP and BNP,and 24 h-ECG monitoring was performed before and after treatment.Premature beat number and HRV indicators,including SDNN,SDANN,RMSSD,SDNNI,and PNN50 were detected.Results:ESR,HCT,np,nbh,and nbl after treatment in the observation group were significantly lower than those in the control group(P<0.05).CRP,VEGF,and BNP after treatment in the observation group were significantly lower than those in the control group(P<0.05).SDNN,SDANN,and PNN50 after treatment in the observation group were significantly higher than those in the control group(P<0.05).Conclusions:Shensong Yangxin capsule in combined with metroprolol succinate can effectively improve the hemodynamcis in patients with arrhythmia of CHD,alleviate the inflammatory reaction,improve HRV,and enhance the therapeutic effect.
引文
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