不同剂量比索洛尔对急性心肌梗死患者心电生理指标影响.docVIP

不同剂量比索洛尔对急性心肌梗死患者心电生理指标的影响 　　【摘要】 目的 探讨不同剂量比索洛尔对急性心肌梗死患者心电生理指标的影响。方法 40例急性心肌梗死患者随机分为对照组和实验组， 每组20例。对照组患者应用小剂量比索洛尔治疗， 实验组患者实施大剂量比索洛尔治疗。观察比较两组患者心电生理指标差异。结果 实验组患者QT、心率变异性时域、频域指标及JT离散度同对照组比较均明显改善， 差异均具有统计学意义（P0.05）。结论 针对急性心肌梗死患者应用大剂量比索洛尔治疗可明显改善心电生理指标， 促进患者康复， 临床值得推广应用。 　　【关键词】 不同剂量；比索洛尔；急性心肌梗死；心电生理指标 　　DOI：10.14163/j.cnki.11-5547/r.2015.31.010 　　Influence of different doses of bisoprolol on cardiac electrophysiology index in acute myocardial infarction patients ZHU Jun-guo. Department of Cardiology， Jiangsu Taizhou City People’s Hospital， Taizhou 225300， China 　　【Abstract】 Objective To investigate influence of different doses of bisoprolol on cardiac electrophysiology index in acute myocardial infarction patients. Methods A total of 40 acute myocardial infarction patients were randomly divided into control group and experimental group， with 20 cases in each group. The control group received small dose of bisoprolol for treatment， and the experimental group received large dose of bisoprolol for treatment. Differences of cardiac electrophysiology index between the two groups were observed. Results The experimental group had much obviously improved QT， indicators of heart rate variability in time domain and frequency domain， and JT dispersion than the control group， and their differences all had statistical significance （P0.05）. Conclusion Implement of large dose of bisoprolol for acute myocardial infarction patients can obviously improve cardiac electrophysiology index and accelerate rehabilitation in patients. It is worthy of clinical promotion and application. 　　【Key words】 Different doses； Bisoprolol； Acute myocardial infarction； Cardiac electrophysiology index 　　近年来， 我国急性心肌梗死发病率呈现明显增加趋势， 严重威胁患者生命安全。急性心肌梗死患者因心肌缺血等引发心电不稳定， 最终导致恶性心律失常。急性心肌梗死后出现左心室进行性扩张、出现外形改善， 被称为梗死后心室重构[1]。心率变异性（HRV）为临床评价自主神经功能的公认指标， 其为心肌梗死预后判断的重要标准。QT离散度（QTd）和JT离散度（JTd）可有效反映电活动不稳定性， 同恶性心脏病发生密切相关。比索洛尔为β1受体阻断剂， 与美托洛尔比较具有更高选择性， 比索洛尔无内源性拟交感活性。文献报道[2]， 比索洛尔可降低心率变异性指标。但目前不同剂量比索洛尔对急性心肌梗死患者变异时域的影响报道较少。