血管成形术,经腔,经皮冠状动脉%药物疗法%心绞痛,不稳定型%自主神经系统疾病%C反应蛋白质
血管成形術,經腔,經皮冠狀動脈%藥物療法%心絞痛,不穩定型%自主神經繫統疾病%C反應蛋白質
혈관성형술,경강,경피관상동맥%약물요법%심교통,불은정형%자주신경계통질병%C반응단백질
Angioplasty,transluminal,pereutaneous eoronary%Drug therapy%Angina unstable%Autonomic nervous system diseases%C-reactive protein
目的 探讨介入治疗与常规药物治疗对伴QRS波碎裂(fQRS)不稳定心绞痛(UA)患者自主神经及C反应蛋白(CRP)的影响. 方法 收集伴QRS波群碎裂UA患者60例,年龄(46.2± 10.3)岁,分为药物组和介入组,各30例.测定两组治疗前和治疗后1个月时心率变异性(H RV)、窦性心率震荡(HRT)和CRP变化. 结果 (1)HRV时域指标(SDNN、SDANN、rMSSD、PNN50、HF、LF)治疗前介入组分别为[(88.2±20.6)ms、(76.2±9.3)ms、(18.6±7.9)ms、(5.5±2.8)％、(219.4±131.6) Hz、(459.6±135.2)Hz]、治疗后介入组分别为[(122.5±15.5) ms、(105.3±5.2)ms、(49.3±4.3)ms、(9.1±1.8)％、(292.5±125.5)Hz、(345.1±175.1)Hz],治疗前后比较为(t=9.4、15.69、8.37、4.68、3.26、3.57,P＜0.01或0.05)；治疗前药物组分别为[(86.9±23.4 )ms、(74.3±10.4)ms,(19.3±7.4)ms、(5.3±2.1)％、(217.2±133.2) Hz、(445.8±144.3)Hz],治疗后药物组分别为[(106.7±18.8)ms、(89.8±7.6)ms、(29.4±5.2)ms、(7.2±3.2)％、(213.2±120.2)Hz、(396.1±182.3)Hz],治疗前后比较(t=7.3、12.36、6.98、2.94、4.89、5.01,P＜0.01或0.05)；治疗后介入组与药物组比较,介入组变化更为显著(t=8.90、13.75、7.52、3.27、4.21、4.01,P＜0.01或0.05).(2)震荡初始(TO)、震荡斜率(TS)、CRP治疗前介入组分别为(0.45±0.44)％、(2.12±0.13)ms/RR、(5.74±2.46)mg/L,治疗后分别为(0.16±0.20)％、(2.98±0.25)ms/RR、(2.61±1.22) mg/L;治疗前药物组分别为(0.49±0.38)％、(2.15±0.19) ms/RR、(5.81±2.35)mg/L,治疗后分别为(0.32±0.26)％、(2.51±0.11)ms/RR、(3.56±1.43)mg/L.TO治疗前后比较药物组为(t=16.78,P=0.001),介入组为(t=15.63,P＜0.01),治疗后介入组与药物组比较(t=15.95,P＜0.001);TS治疗前后比较药物组为(t=19.52,P=0.001),介入组为(t=14.36,P=0.001),与药物组比较介入组变化更为显著(t=18.13,P=0.001)；CRP治疗前后比较药物组为(t=9.76,P=0.01),介入组为(t=12.49,P=0.001),治疗后介入组与药物组比较为(t=10.73,P=0.001). 结论 冠脉介入治疗更显著改善伴QRS波碎裂UA患者的心肌供血,从而减轻炎症反应,改善自主神经功能.
目的 探討介入治療與常規藥物治療對伴QRS波碎裂(fQRS)不穩定心絞痛(UA)患者自主神經及C反應蛋白(CRP)的影響. 方法 收集伴QRS波群碎裂UA患者60例,年齡(46.2± 10.3)歲,分為藥物組和介入組,各30例.測定兩組治療前和治療後1箇月時心率變異性(H RV)、竇性心率震盪(HRT)和CRP變化. 結果 (1)HRV時域指標(SDNN、SDANN、rMSSD、PNN50、HF、LF)治療前介入組分彆為[(88.2±20.6)ms、(76.2±9.3)ms、(18.6±7.9)ms、(5.5±2.8)％、(219.4±131.6) Hz、(459.6±135.2)Hz]、治療後介入組分彆為[(122.5±15.5) ms、(105.3±5.2)ms、(49.3±4.3)ms、(9.1±1.8)％、(292.5±125.5)Hz、(345.1±175.1)Hz],治療前後比較為(t=9.4、15.69、8.37、4.68、3.26、3.57,P＜0.01或0.05)；治療前藥物組分彆為[(86.9±23.4 )ms、(74.3±10.4)ms,(19.3±7.4)ms、(5.3±2.1)％、(217.2±133.2) Hz、(445.8±144.3)Hz],治療後藥物組分彆為[(106.7±18.8)ms、(89.8±7.6)ms、(29.4±5.2)ms、(7.2±3.2)％、(213.2±120.2)Hz、(396.1±182.3)Hz],治療前後比較(t=7.3、12.36、6.98、2.94、4.89、5.01,P＜0.01或0.05)；治療後介入組與藥物組比較,介入組變化更為顯著(t=8.90、13.75、7.52、3.27、4.21、4.01,P＜0.01或0.05).(2)震盪初始(TO)、震盪斜率(TS)、CRP治療前介入組分彆為(0.45±0.44)％、(2.12±0.13)ms/RR、(5.74±2.46)mg/L,治療後分彆為(0.16±0.20)％、(2.98±0.25)ms/RR、(2.61±1.22) mg/L;治療前藥物組分彆為(0.49±0.38)％、(2.15±0.19) ms/RR、(5.81±2.35)mg/L,治療後分彆為(0.32±0.26)％、(2.51±0.11)ms/RR、(3.56±1.43)mg/L.TO治療前後比較藥物組為(t=16.78,P=0.001),介入組為(t=15.63,P＜0.01),治療後介入組與藥物組比較(t=15.95,P＜0.001);TS治療前後比較藥物組為(t=19.52,P=0.001),介入組為(t=14.36,P=0.001),與藥物組比較介入組變化更為顯著(t=18.13,P=0.001)；CRP治療前後比較藥物組為(t=9.76,P=0.01),介入組為(t=12.49,P=0.001),治療後介入組與藥物組比較為(t=10.73,P=0.001). 結論 冠脈介入治療更顯著改善伴QRS波碎裂UA患者的心肌供血,從而減輕炎癥反應,改善自主神經功能.
목적 탐토개입치료여상규약물치료대반QRS파쇄렬(fQRS)불은정심교통(UA)환자자주신경급C반응단백(CRP)적영향. 방법 수집반QRS파군쇄렬UA환자60례,년령(46.2± 10.3)세,분위약물조화개입조,각30례.측정량조치료전화치료후1개월시심솔변이성(H RV)、두성심솔진탕(HRT)화CRP변화. 결과 (1)HRV시역지표(SDNN、SDANN、rMSSD、PNN50、HF、LF)치료전개입조분별위[(88.2±20.6)ms、(76.2±9.3)ms、(18.6±7.9)ms、(5.5±2.8)％、(219.4±131.6) Hz、(459.6±135.2)Hz]、치료후개입조분별위[(122.5±15.5) ms、(105.3±5.2)ms、(49.3±4.3)ms、(9.1±1.8)％、(292.5±125.5)Hz、(345.1±175.1)Hz],치료전후비교위(t=9.4、15.69、8.37、4.68、3.26、3.57,P＜0.01혹0.05)；치료전약물조분별위[(86.9±23.4 )ms、(74.3±10.4)ms,(19.3±7.4)ms、(5.3±2.1)％、(217.2±133.2) Hz、(445.8±144.3)Hz],치료후약물조분별위[(106.7±18.8)ms、(89.8±7.6)ms、(29.4±5.2)ms、(7.2±3.2)％、(213.2±120.2)Hz、(396.1±182.3)Hz],치료전후비교(t=7.3、12.36、6.98、2.94、4.89、5.01,P＜0.01혹0.05)；치료후개입조여약물조비교,개입조변화경위현저(t=8.90、13.75、7.52、3.27、4.21、4.01,P＜0.01혹0.05).(2)진탕초시(TO)、진탕사솔(TS)、CRP치료전개입조분별위(0.45±0.44)％、(2.12±0.13)ms/RR、(5.74±2.46)mg/L,치료후분별위(0.16±0.20)％、(2.98±0.25)ms/RR、(2.61±1.22) mg/L;치료전약물조분별위(0.49±0.38)％、(2.15±0.19) ms/RR、(5.81±2.35)mg/L,치료후분별위(0.32±0.26)％、(2.51±0.11)ms/RR、(3.56±1.43)mg/L.TO치료전후비교약물조위(t=16.78,P=0.001),개입조위(t=15.63,P＜0.01),치료후개입조여약물조비교(t=15.95,P＜0.001);TS치료전후비교약물조위(t=19.52,P=0.001),개입조위(t=14.36,P=0.001),여약물조비교개입조변화경위현저(t=18.13,P=0.001)；CRP치료전후비교약물조위(t=9.76,P=0.01),개입조위(t=12.49,P=0.001),치료후개입조여약물조비교위(t=10.73,P=0.001). 결론 관맥개입치료경현저개선반QRS파쇄렬UA환자적심기공혈,종이감경염증반응,개선자주신경공능.
Objective To investigate the effects of percutaneous coronary intervention(PCI) and conventional drugs on autonomic nervous system and C-reactive protein (CRP)in the patients with unstable angina pectoris combined by QRS complex fragment. Methods A total of 60 patients aged (46.2± 10.3) years with unstable angina combined by QRS complex fragment were randomly divided into drug therapy group and PCI group (n=30 for each group).The changes of heart rate variability (HRV) including SDNN,SDANN,rMSSD,PNN50,HF and LF,heart rate turbulence(HRT) such as TO and TS,and CRP were measured before and 1 month after treatment. Results The values of SDNN[(88.2±20.6)ms vs.(122.5 ± 15.5)ms; (86.9± 23.4)ms vs.( 106.7± 18.8)ms],SDANN [(76.2±9.3)ms vs.(105.3±5.2)ms; (74.3±10.4)ms vs.(89.8±7.6)ms],rMSSD[(18.6±7.9)ms vs.(49.3± 4.3)ms; (19.3± 7.4)ms vs.(29.4± 5.2)ms],PNN50 [(5.5± 2.8)％ vs.(9.1 ±1.8)％; (5.3±2.1)％ vs.(7.2±3.2)％],HF[(219.4±131.6) Hz vs.(292.5±125.5) Hz;(217.2±133.2) Hz vs.(213.2±120.2 ) Hz] and LF[(459.6±135.2) Hz vs.(345.1±175.1) Hz ;(445.8± 144.3) Hz vs.(396.1 ± 182.3) Hz] were improved after treatment as compared with pretreatment in PCI group (t=9.4,15.69,8.37,4.68,3.26,3.57,P＜0.01 or 0.05) and in drug therapy group (t=7.3,12.36,6.98,2.94,4.89,5.01,P＜0.01 or 0.05),respectively.The changes of above indexes were more remarkable in PCI group than in drug therapy group(t=8.90,13.75,7.52,3.27,4.21,4.01,P＜0.01 or 0.05).The values of turbulence onset(TO) [(0.45±0.44)％ vs.(0.16±0.20)％,t=15.63,P＜0.01; (0.49±0.38)％ vs.(0.32±0.26)％,t=16.78,P=0.001] and turbulence slope (TS) [(2.12±0.13)ms/RR vs.(2.98±0.25)ms/RR,t=14.36,P=0.001; (2.15±0.19)ms/RR vs.(2.51±0.11)ms/RR,t=19.52,P=0.001] and CRP [(5.74±2.46)mg/L vs.(2.61±1.22)mg/L,t=12.49,P=0.001; (5.81±2.35)mg/Lvs.(3.56±1.43)mg/L,t=9.76,P=0.01] were also improved after treatment as compared with before treatment in PCI and drug therapy groups,respectively,and the the changes in TO (t=15.95,P＜0.001),TS (t=18.13,P=0.001) and CRP(t=10.73,P=0.001) were more obvious in PCI group than in medicine group. Conclusions PCI may obviously reduce inflammatory response,provide more myocardial blood supply and improve autonomic nervous function in the patients with unstable angina pectoris combined by QRS complex fragment.
