發(fā)布時(shí)間：2018-07-08 13:02

  本文選題：阿托伐他汀 + 心肌梗死��； 參考：《青島大學(xué)》2017年碩士論文

【摘要】：目的觀察阿托伐他汀對(duì)心肌梗死合并糖尿病患者心率變異性的影響。方法選取2015年6月-2016年6月于我院住院的心肌梗死合并糖尿病患者110例,采用隨機(jī)數(shù)字法分為實(shí)驗(yàn)組和對(duì)照組,對(duì)照組采用常規(guī)治療(酒石酸美托洛爾12.5mg~50mg,bid;硝酸異山梨酯5~10 mg,tid;阿司匹林腸溶片100mg,qn;阿托伐他汀10mg,qn,實(shí)驗(yàn)組在常規(guī)治療基礎(chǔ)上強(qiáng)化阿托伐他汀治療(阿托伐他汀40mg,qn)療程6個(gè)月。治療前后測(cè)定心率變異性時(shí)域參數(shù)SDNN,SDNNI,SDANN;RMSSD;PNN50,和頻域參數(shù)高頻功率(HF)和低頻功率(LF),其中以SDNN、RMSSD、SDNNI、SDANN、PNN50代表HRV時(shí)域指標(biāo),以HF代表迷走神經(jīng)活性,LF代表交感神經(jīng)活性.所得實(shí)驗(yàn)數(shù)據(jù)采用SPSS 17.0統(tǒng)計(jì)軟件進(jìn)行統(tǒng)計(jì)學(xué)處理,計(jì)量資料以均數(shù)±標(biāo)準(zhǔn)差(x±s)表示,兩樣本均數(shù)之間統(tǒng)計(jì)學(xué)差異t檢驗(yàn),單因素分析用方差分析,然后兩兩比較再用x2檢驗(yàn),P0.05為差異有統(tǒng)計(jì)學(xué)意義。比較兩組臨床效果。結(jié)果1.研究對(duì)象一般情況比較兩組研究對(duì)象年齡、性別和BMI差異無統(tǒng)計(jì)學(xué)意義(P0.05)。兩組研究對(duì)象常規(guī)檢測(cè)指標(biāo)差異無統(tǒng)計(jì)學(xué)意義(P0.05)。2.兩組治療前后血脂比較治療前兩組血脂水平無明顯差異,治療后兩組血脂均有所下降,但實(shí)驗(yàn)組下降較對(duì)照組更顯著。3.實(shí)驗(yàn)組治療前后HRV參數(shù)比較與治療前相比,治療后實(shí)驗(yàn)組,時(shí)域指標(biāo)SDNN、SDANN、SDNNI、RMSSD值均明顯好轉(zhuǎn),有統(tǒng)計(jì)學(xué)意義(P0.05),PNN50值差異不顯著(P0.05).其頻域指標(biāo)LF、HF亦有顯著差異(P0.05)。4.對(duì)照組治療前后HRV參數(shù)比較治療后HRV指標(biāo)有一定改善,但其值并無統(tǒng)計(jì)學(xué)意義(P0.05)。5.兩組治療前后HRV參數(shù)比較治療后實(shí)驗(yàn)組與對(duì)照組比較,其時(shí)域指標(biāo)SDNN、SDANN、SDNNI、RMSSD值均明顯好轉(zhuǎn),有統(tǒng)計(jì)學(xué)意義(P0.05),PNN50值差異不顯著(P0.05).其頻域指標(biāo)LF、HF亦有顯著差異(P0.05)。結(jié)論6個(gè)月的強(qiáng)化阿托伐他汀治療可顯著改善心肌梗死合并糖尿病患者心率變異性。
[Abstract]:Objective to observe the effect of Atto vastatin on heart rate variability in patients with myocardial infarction and diabetes mellitus. Methods 110 patients with myocardial infarction complicated with diabetes mellitus from June 2015 to June 2016 were randomly divided into experimental group and control group. The control group was treated with routine therapy (metoprolol tartrate 12.5 mg / L 50 mg / g bid; isosorbide nitrate 10 mg / kg tid; aspirin enteric-coated tablet 100 mg / g QN; Atto vastatin 10 mg / g QN). The experimental group was treated with Atto vastatin (40 mg / g QN) for 6 months on the basis of routine treatment. The time domain parameters of heart rate variability (SDNN), SDNNV SDNNIN, RMSSDN PN50, frequency domain parameters HF and low frequency power (LF) were measured before and after treatment. Among them, SDNNV RMSSDN SDNN 50 represented HRV time domain index, HF represented vagus nerve activity and LF represented sympathetic nerve activity. The experimental data were processed by SPSS 17.0 statistical software. The measured data were expressed as mean 鹵standard deviation (x 鹵s). T test of statistical difference between the two samples and analysis of variance were used in single factor analysis. Then pairwise comparison with X 2 test for the difference was statistically significant. To compare the clinical effect between the two groups. Result 1. There was no significant difference in age, sex and BMI between the two groups (P0.05). There was no significant difference between the two groups (P0.05). There was no significant difference in blood lipid levels between the two groups before and after treatment, but the blood lipid levels in the experimental group were lower than those in the control group, but the decrease in the experimental group was more significant than that in the control group. The parameters of HRV before and after treatment in the experimental group were significantly improved compared with those before and after treatment, and there was no significant difference in the value of PNN50 between the two groups (P0.05). The frequency domain index LFN HF also had significant difference (P0.05). 4. The parameters of HRV in the control group were improved after treatment, but the values were not statistically significant (P0.05). Comparison of HRV parameters before and after treatment between the experimental group and the control group, the time domain index of SDNNN SDANNNNINNIN RMSSD was significantly improved, and there was no significant difference in PN50 between the two groups (P0.05). The frequency domain index LFN HF also had significant difference (P 0.05). Conclusion 6 months intensive Atto vastatin therapy can significantly improve heart rate variability in patients with myocardial infarction and diabetes.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R542.22;R587.1

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