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目的:观察培哚普利对充血性心力衰竭(congestive heart failure,CHF)心率变异性(heart rate variability,HRV)的影响,以探讨培哚普利治疗CHF的可能机制。方法:选择24例CHF患者,测量治疗前后HRV各项指标的变化,并与22名健康志愿者进行对照。结果:治疗前CHF患者HRV所有成分除低频功率(LF)/高频功率(HF)外较正常对照者均显著下降(P<0·001)。治疗后培哚普利组正常R-R间期的标准差(SDNN)、节段平均R-R间期的标准差(SDANN)、总功率(TP)、极低频功率(VLF)、LF、HF增加非常显著(P<0·01),相邻R-R间期差值的均方根(RMSSD)显著增加(P<0·05),而标准差的平均值(SDNNindex)、相邻R-R间期差值大于50ms记数占总R-R间期数的百分比(PNN50)有增加趋势,但无统计学意义(P>0·05);LF/HF有减小趋势,无统计学意义(P>0·05)。结论:培哚普利可以改善心脏自主神经功能的失衡,其作用机制可能与降低交感神经张力、增加迷走神经张力有关。
Objective: To observe the effect of perindopril on heart rate variability (HRV) in patients with congestive heart failure (CHF) and to explore the possible mechanism of perindopril in the treatment of CHF. Methods: Twenty-four CHF patients were selected to measure the changes of HRV before and after treatment, and compared with 22 healthy volunteers. Results: All the HRV components in CHF patients before treatment were significantly lower than those in normal controls (P <0.001), except for low-frequency power (LF) and high-frequency power (HF). The standard deviation (SDNN), SDANN, TP, VLF, LF and HF of the normal RR interval in perindopril group were significantly increased after treatment (P <0.01), and the root mean square (RMSSD) of adjacent RR intervals increased significantly (P <0.05). However, the mean value of standard deviations (SDNNindex) and the difference between adjacent RR intervals were greater than The proportion of 50ms counting to the total number of RR intervals (PNN50) had an increasing tendency, but there was no statistical significance (P> 0.05). The LF / HF tended to decrease with no statistical significance (P> 0.05) . CONCLUSION: Perindopril can improve the imbalance of cardiac autonomic nervous function. Its mechanism may be related to the reduction of sympathetic tone and increase of vagal tone.