目的 探討丹參多酚酸鹽注射液對(duì)高齡冠心病患者心肌缺血及心率變異性的影響。方法 選擇寶雞市中心醫(yī)院2016年4月-2018年5月收治的78例高齡冠心病心肌缺血患者，根據(jù)隨機(jī)數(shù)字表法分為觀察組及對(duì)照組。對(duì)照組給予常規(guī)治療，觀察組在對(duì)照組基礎(chǔ)上加用丹參多酚酸鹽。觀察兩組治療前后的ST段壓低總次數(shù)、總時(shí)間、24 h正常RR間期標(biāo)準(zhǔn)差（SDNN）、24 h內(nèi)每5分鐘正常RR間期平均值標(biāo)準(zhǔn)差（SDANN）、心電圖療效及心率變異性改善療效，觀察兩組心功能指標(biāo)[左室射血分?jǐn)?shù)（LVEF）、心輸出量（CO）、B型利鈉肽（BNP）]及不良反應(yīng)。結(jié)果 治療前，兩組的ST段壓低總次數(shù)、ST段壓低總時(shí)間對(duì)比無(wú)統(tǒng)計(jì)學(xué)意義；治療后兩組的ST段壓低總次數(shù)、ST段壓低總時(shí)間均明顯下降，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療后觀察組明顯低于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。觀察組的心電圖總有效率明顯高于對(duì)照組，組間差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療前，兩組的SDNN、SDANN對(duì)比無(wú)統(tǒng)計(jì)學(xué)意義；治療后，對(duì)照組與治療前對(duì)比無(wú)統(tǒng)計(jì)學(xué)意義；觀察組的SDNN、SDANN明顯高于治療前及對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療前，兩組的LVEF、CO、BNP水平對(duì)比無(wú)統(tǒng)計(jì)學(xué)意義；治療后，兩組的LVEF、CO明顯上升，BNP明顯降低，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療后觀察組LVEF、CO明顯高于對(duì)照組，BNP明顯低于對(duì)照組，組間差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。兩組不良反應(yīng)對(duì)比無(wú)統(tǒng)計(jì)學(xué)意義。結(jié)論 丹參多酚酸鹽注射液可顯著改善高齡冠心病患者的心肌缺血及心率變異性，且用藥安全，值得臨床推廣應(yīng)用。

Objective To investigate the effect of Danshen Polyphenolate Injection on myocardial ischemia and heart rate variability in elderly patients with coronary heart disease. Methods 78 elderly patients with coronary heart disease from April 2016 to May 2018 in our hospital were chosen and divided into the observation group and control group. The control group were given conventional treatment, the observation group were given Danshen Polyphenolate Injection on the base of control group, the ST total number times, total time, SDNN, SDANN of two groups before and after treatment, the electrocardiogram efficacy and heart rate variability improved efficacy of two groups had no significant difference. After treatment, the ST total number times, total time, adverse reaction of two groups were compared. Results The ST total number times and total time of two groups before treatment had no significant difference. After treatment, the ST total number times and total time were decreased than before treatment, and the observation group was lower than control group (P<0.05); the electrocardiogram efficacy of observation group was higher than control group(P<0.05). The SDNN, SDANN of two groups before treatment had no significant difference. After treatment, the SDNN, SDANN of control group had no significant difference than before, the observation group were higher than before and control group (P<0.05). The LVEF, CO, BNP of two groups before treatment had no significant difference. After treatment, the LVEF, CO of two groups were obvious higher than before, and the observation group was higher than control group. After treatment, the BNP of two groups were obvious lower than before, the observation group was lower than control group (P<0.05). The adverse reaction of two groups had no significant difference. Conclusion The Danshen Polyphenolate Injection could improve the myocardial ischemia and heart rate variability in elderly patients with coronary heart disease, and which was safe and could be worth of clinical promotion application.

R972