美托洛尔联合阿托伐他汀治疗对心力衰竭患者心率变异性及远期疗效的影响

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Abstract ObjectiveTo discuss the impact of Metoprolol combined with Atorvastatin on heart rate variability and long-term effect in patients with heart failure.MethodsA case-control study design was used.Patients with chronic heart failure treated in our hospital from January 2011 to December 2012 were retrospectively selected according to the certain entry criteria.The case group was patients matching the entry criteria and given Atorvastatin treatment and the control group was patients matching the entry criteria and had no Atorvastatin treatment.The timing of initiation of statin use was used as a basic matched condition for including control(within 1 weeks of admission),while matching age and sex.120 patients were included with 60 cases in case group and 60 cases in control group.Standardized treatment including Metoprolol of CHF was used in each group.After 12-month follow-up,each index change of heart function and heart rate variability before treatment and after 6 months treatment in patients of the two groups were observed.Before treatment and after 12 months treatment,SF-36 scale was used to evaluate the quality of life score in patients of the two groups.The survival state and adverse reactions of 6 and 12 months during treatment were compared between the two groups.ResultsLVEF was(49.38±6.42)%in case group after 6-months treatment,which was higher thanthat in control group[(43.34±6.18)%],and the difference was statistically significant(P＜0.05).LVEDD and LVESD were (60.39±3.02)mm and (41.25±5.68)mm in case group after 6-months treatment,which were lower than that in control group [(63.94±2.67),(46.73±5.76)mm]and the difference was statistically significant(P＜0.05).SDNN,SDANN,rMSSD and PNN50 were(116.79±20.54)ms,(108.22±13.04)ms,(22.74±6.12)ms and(12.76±4.83)%in case group after 6-months treatment,which were all higher than that in control group [(92.38±18.72)ms,(92.31±12.58)ms,(15.73±5.78)ms,(8.29± 2.74)%]and the difference was statistically significant(P＜0.05).After 12 months,physiological function,physiological function,body pain,general health,vitality,social function,emotional function and mental health score of 8 dimensions in patients of case group patients were higher than those in control group,there was significant difference between the two groups(P＜0.05).The survival rate of 12 month in case group was 88.33%,which was higher than that(73.33%)of control group,but the difference between the two groups was not statistically significant(P＞0.05).Conclusion Metoprolol combined with atorvastatin can effectively improve cardiac function in patients with CHF,improve the heart rate variability,but also can improve the quality of life of patients,and it is safe and effective,although the survival rate of patients with has no obvious improvement,but in clinical practice,patient status given individual analysis to conduct the discretionary use.

Key words： Metoprolol Atorvastatin Heart failure Heart rate variability Mortality

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	Articles by authors
	XIE Yang
	ZHOU Hao-yue
	HUANG Wei-peng
	LIN Yu-peng
	ZHANG Hua-di

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XIE Yang,ZHOU Hao-yue,HUANG Wei-peng, et al. Impact of Metoprolol combined with Atorvastatin on heart rate variability and long-term effect in patients with heart failure[J]. 中国当代医药, 2017, 24(19): 39-43.

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