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目的:探讨早期应用小剂量洋地黄类药物对急性心肌梗死(Acute myocardial infarction,AMI)行经皮冠状动脉介入治疗(Percutaneous coronary intervention,PCI)术后合并心力衰竭患者心率变异性(Heart rate variability,HRV)的影响。方法:入选32例在发病24小时内接受PCI治疗且合并心力衰竭的AMI患者,再灌注后随机分为洋地黄组(西地兰0.2 mg,n=17)和对照组(生理盐水20 m L,n=15)。在用药前、用药后30分钟、用药后3小时、用药后6小时、用药后12小时、用药后24小时进行5分钟HRV分析。结果:1洋地黄组的心率在用药6小时后显著小于对照组(P<0.05);2洋地黄组SDNN在用药后3小时-6小时显著大于对照组(P<0.05),两组RMSSD比较无显著统计学差别(P>0.05);3洋地黄组LFnorm在用药后3小时-6小时显著大于对照组(P<0.05);用药3小时后,洋地黄组HFnorm显著大于对照组(P<0.05),LF/HF显著小于对照组(P<0.05)。结论:小剂量洋地黄可以显著降低AMI PCI术后合并心力衰竭患者的心率、逆转迷走神经与交感神经活性的失衡状态,改善HRV。
Objective: To investigate the effect of early application of small dose digitalis drugs on heart rate variability (HRV) in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI) )Impact. Methods: Thirty-two AMI patients who underwent PCI within 24 hours after onset of PCI with heart failure were randomly divided into digitalis group (cedilanid 0.2 mg, n = 17) and control group (saline 20 m L , n = 15). Before treatment, 30 minutes after administration, 3 hours after administration, 6 hours after administration, 12 hours after administration, HRV analysis was performed for 5 minutes 24 hours after administration. Results: 1 The heart rate of digitalis was significantly lower than that of the control group 6 hours after treatment (P <0.05); 2 The digitalis SDSD of digitalis was significantly higher than that of the control group 3 hours and 6 hours after administration (P <0.05) (P> 0.05) .3 The LFnorm of digitalis group was significantly higher than that of the control group 3hours to 6hours after administration (P <0.05), HFnorm in digitalis group was significantly higher than that of the control group 3hours after treatment (P < 0.05), LF / HF was significantly less than the control group (P <0.05). CONCLUSION: A small dose of digitalis significantly reduces the heart rate in patients with heart failure after AMI PCI, reverses the unbalanced vagal and sympathetic activity, and improves HRV.