【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。更多还原

【Abstract】 Objective To explore plasma magnesium concentration(PMC),erythrocyte magnesium content(EMC),erythrocyte Na+/Mg2+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),erythrocyte magnesium content(EMC)and Na+/Mg2+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,VNImax,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 VNImax 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+/Mg2+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.更多还原