比索洛尔对高血压左室肥厚患者心室跨壁离散度及室性心律失常的影响

摘要

目的：观察比索洛尔对高血压左室肥厚患者心室跨壁离散度及室性心律失常的影响。方法选择高血压病并经过M型超声心动图确定有左室肥厚的患者120例，随机分为治疗组和对照组各60例，予除β受体阻滞剂以外的常规降压治疗，治疗组加比索洛尔口服治疗，2．5 mg·d-1开始，根据病情每周调整一次服药量，达到最大耐受量10 mg·d-1为止，疗程为8周。通过测量治疗前后心电图V2导联T波峰-末间期（T peak-end interval，Tp-e间期）和QT离散度（QT dispersion，QTd）及采用心律失常Lown分级标准评价心室跨壁离散度和室性心律失常的变化。结果治疗前两组Tp-e间期、QTd及室性心律失常比较差异无统计学意义（P＞0．05），治疗8周后治疗组与对照组相比Tp-e间期和QTd指标差异有统计学意义（P＜0．05），比索洛尔治疗组Tp-e间期和QTd明显缩短，室性心律失常减少。结论比索洛尔可降低高血压左室肥厚患者的心室跨壁离散度，防治恶性心律失常，减少猝死。%Objective To investigate the effect of bisoprolol on ventricle transmural dispersion of repolarization(TDR)and ventricular arrhythmia in patients with hypertensive left ventricular hypertrophy.Methods A hundred and twenty patients of primary hypertension with left ventricular hypertrophy were selected according to the results detected by color Doppler echocardiography.All these patients were randomly assigned into two groups with 60 in each.Control group was treated by the conventional therapy without β-blocker,and the managed group was treated with bisoprolol,2.5 mg·d-1 without adverse drug reaction and then to maximal dose(1 0 mg·d-1 ) weekly which patients were able to tolerate.All patients were followed up for a period of 8 weeks.Tp-e interval and QT dispersion (QTd)were measured by ECG V2 lead before and after treatment and ventricular arrhythmias were analyzed with Lown’s scales classi-fication.Results There were no significant differences in Tp-e interval and QTd and arrhythmias before treatment in two groups(P>0.05)Compared with before treatment,Tp-e interval andQTdwere obviously shortened(P<0.05),and the occurrence of ventricular ar-rhythmias was decreased significantly in the patients after 8 weeks of bisoprolol therapy(P<0.05).Conclusions Bisoprolol can de-crease ventricle transmural dispersion of repolarization and malignant arrhythmias in patients with hypertensive left ventricular hypertro-phy and reduce the possibility of sudden death.