摘要
目的探讨慢性心力衰竭患者缬沙坦治疗后,血浆镁浓度(PMC)、红细胞镁含量(EMC)和红细胞Na+/Mg2+交换速率与心律失常的相关性。方法收集2006年3月至2007年3月哈尔滨医科大学第一临床医学院心内科128例充血性心力衰竭病例并随机分为两组,常规治疗加缬沙坦组(观察组)和不加缬沙坦组(对照组),采用原子吸收光谱火焰法测定两组治疗前、治疗6个月后PMC、EMC以及Na+/Mg2+交换速率,以Holter检测两组治疗6个月时心律失常发生情况。结果(1)治疗前两组PMC、EMC、VTmax(红细胞总镁外流量最大速度)、VNImax(红细胞非钠依赖性镁外流最大速度)、VNDmax(红细胞钠依赖性镁外流最大速度)比较差异无统计学意义(P>0.05)。(2)治疗6个月后,观察组PMC、EMC与对照组比较差异均有统计学意义(P<0.05,P<0.01);观察组VNImax与对照组比较差异无统计学意义(P>0.05);观察组VTmax、VNDmax与对照组比较均明显降低,差异均有统计学意义(P<0.01)。(3)两组治疗6个月后,观察组各种心律失常的发生较对照组显著减少。结论(1)心衰治疗加缬沙坦后,Na+/Mg2+交换速率降低,PMC与EMC增加,并由此减少了各种心律失常的发生。(2)缬沙坦的抗心律失常作用可能与增加了细胞的Mg2+稳态有关。
Objective To explore plasma magnesium concentration（PMC） ,erythrocyte magnesium content（EMC） ,erythroeyte Na ^＋/Mg^2 ＋ exchange rate and arrhythmia in patients with chronic heart failure with or without valsartan treatment. Methods A total of 128 patients with chronic heart failure were randomly divided into two groups. Group one：standard treatment with valsartan therapy;group two：standand treatment without valsartan therapy. Plasma magnesium concentration （ PMC）, erythroeyte magnesium content （EMC） and Na^＋/Mg^2＋ exchange rate were measured by flame assay of atomic absorption spectrophotometer before treatment and after 6 months＇ treatment. The 24 h-Holter was observed for arrhythmias in the two groups after 6 months＇ treatment. Results （ 1 ） There was no significant difference in PMC, EMC, VTmax , VNlmax , VNDmax between the two groups（ P 〉 0. 05 ）before treatment. （2）After 6 months＇ treatment, there was significant difference in PMC and EMC（ P 〈 0. 05 ,P 〈 0. 01 ） and no significant difference in VNlmax between the two groups（P 〉 0.05 ）. VNDmax and VTmax were significantly lower in group one than in group two（ P 〈 0. 01 ）. （ 3 ） The arrhythmia occurrence in group one was lower than that in group two after 6 months＇ therapy. Conclusion （ 1 ） Decreased VNDmax caused by inhibition of Na ^＋ / Mg^2＋ exchange rate in patients with chronic heart failure treated by Valsartan may inhibit the occurrence of arrhythmias. （2） The anti-arrhythmia action of valsartan may relate to enhancing magnesium stability in myocardial cells.
出处
《中国实用内科杂志》
CAS
CSCD
北大核心
2008年第9期754-756,共3页
Chinese Journal of Practical Internal Medicine
