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目的研究倍他乐克对冠心病劳力性心绞痛患者QT间期离散度(QT dispersion)的影响。方法46例劳力性心绞痛患者经随机抽样分为治疗组(n=24)和对照组(n=22),治疗组给予倍他乐克50～150mg/d,对照组不给倍他乐克治疗,两组其它的抗心肌缺血治疗相同或相似。两组患者分别在治疗前及治疗后2周做12导联同步心电图检查,测量心率,最大和最小QT间期,计算QT间期离散度(QTd)及心率校正后QT间期离散度(QTcd)。比较治疗组与对照组治疗前后的QTd变化,用t检验进行统计学处理。结果倍他乐克可以使劳力性心绞痛患者的QTd和QTcd明显缩短(76.5±9.2vs64.5±7.3和74.9±9.2vs63.7±7.3,P<0.01),而对照组患者的QTd和QTcd无显著变化(78.3±4.2vs76.8±5.6和76.7±7.4vs74.7±6.2,P>0.05)。结论倍他乐克在改善心肌缺血的同时可以明显的缩短QTd,从而减少室性心律失常的发生,改善预后,QTd的缩短是β-受体阻滞剂能够有效地改善冠心病预后的一个重要电生理机制。
Objective To investigate the effect of Betaloc on QT dispersion in patients with angina pectoris of coronary heart disease. Methods A total of 46 patients with angina pectoris were divided into treatment group (n = 24) and control group (n = 22) by random sampling. Patients in the treatment group received metoprolol 50 ~ 150 mg / d, while patients in the control group did not receive metoprolol Other anti-ischemic treatments in both groups were the same or similar. Two groups of patients before treatment and 2 weeks after treatment to do 12-lead ECG, heart rate, maximum and minimum QT interval, calculate the QTd and QTd after the correction of heart rate (QTcd ). The QTd changes of the treatment group and the control group before and after treatment were compared, and the t test was used for statistical analysis. Results Betaloc can significantly shorten the QTd and QTcd in patients with angina pectoris (76.5 ± 9.2 vs64.5 ± 7.3 and 74.9 ± 9.2 vs63.7 ± 7.3, P <0.01), while the QTd and QTcd in the control group (78.3 ± 4.2 vs. 76.8 ± 5.6 and 76.7 ± 7.4 vs. 74.7 ± 6.2, P> 0.05). Conclusion Betaloc can significantly reduce QTd while improving myocardial ischemia, thus reducing the occurrence of ventricular arrhythmias and improving prognosis. The shortening of QTd is one of the effective measures to improve the prognosis of coronary heart disease Important electrophysiological mechanisms.