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目的 :探讨美托洛尔对急性心肌梗死 (AMI)后心率变异性 (HRV )及恶性心律失常 (MVA )事件的影响。方法 :将 77例分为美托洛尔组 (4 0例 )及对照组 (37例 ) ,美托洛尔组在常规治疗基础上给予美托洛尔 6 .2 5～ 12 .5 m g,bid,以后根据病情渐加量到 2 5～ 5 0 m g,bid;对照组仅常规治疗 ,并分别测定入院后第 1天、第 7天、0 .5年、1年时 48h动态心电图 ,常规进行 HRV分析 ,并同时观察各阶段 MVA发生率。结果 :1周内两组 HRV及MVA变化差异无显著性意义 ,但美托洛尔组 MVA事件有减少趋势 ,0 .5年后美托洛尔组 HRV显著改善 (P <0 .0 1) ,MVA事件发生率显著低于对照组 (P <0 .0 1)。结论 :美托洛尔能有效改善 AMI后患者 HRV,降低 MVA发生率 ,但此种改变在长时间治疗后明显。
Objective: To investigate the effect of metoprolol on heart rate variability (HRV) and malignant arrhythmia (MVA) events after acute myocardial infarction (AMI). Methods: 77 patients were divided into metoprolol group (40 cases) and control group (37 cases). Metoprolol group was given metoprolol from 6.52 to 12.5 mg on the basis of routine treatment, bid, according to the condition gradually increased to 25 ~ 50mg, bid; control group only conventional treatment, and were measured after admission 1 day, 7 days, 0.5 years, 1 year 48h Holter, conventional HRV analysis, and at the same time observe the incidence of MVA in all stages. Results: There was no significant difference in the changes of HRV and MVA between the two groups in one week, but the MVA events in metoprolol group had a decreasing tendency. After 0.5 years, HRV in metoprolol group was significantly improved (P <0.01) The incidence of MVA was significantly lower than that of the control group (P <0.01). Conclusion: Metoprolol can effectively improve HRV in patients with AMI and reduce the incidence of MVA, but this change is obvious after long-term treatment.