艾司洛尔治疗心肌梗死并急性心功能不全疗效观察_医学论文.docVIP

艾司洛尔治疗心肌梗死并急性心功能不全疗效观察_医学论文 艾司洛尔治疗心肌梗死并急性心功能不全疗效观察_医学论文 作者：杨春强 秦毅 庄建群 王跃明 【摘要】 　　目的 研究超短作用β1受体阻断剂艾司洛尔治疗急性心肌梗死并急性左心功能不全的疗效和安全性。方法 44例Killip心功能Ⅱ级的急性心肌梗死患者随机分两组，研究组除应用溶栓药、低分子肝素、硝酸酯、ACEI、辛伐他汀外，入院即时静脉注射艾司洛尔30 mg/5min，随后24 h以25～50 μg/（min·kg）速度泵入，停药前30 min开始口服倍他乐克。对照组入院第3天开始口服倍他乐克，观察30 d，第21天做超声心动图检查，评价心脏形态和功能变化。结果 所有患者均能良好耐受艾司洛尔，观察期间两组梗死后心绞痛、心律失常、死亡均无差别，研究组心衰加重明显低于对照组（P＜0.01）。超声心动图检查两组心脏结构、功能均无显著差别，研究组射血分数较对照组增加5%（P＞0.05）。结论 艾司洛尔治疗急性心肌梗死并急性左心功能不全安全有效、耐受性好。 【关键词】 急性心肌梗死　急性左心功能不全　艾司洛尔　美托洛尔 　　【Abstract】 Objective The aim of this study was researching the efficacy and safety of the therapy with esmolol,which was β1adrenoblockers with shortterm effect. Methods 44 patients with acute myocardial infarction and heart function of Killip Ⅱ were divided into 2 groups,the study groups were injected 30mg esmolol in 5 minutes by vein when delivered hospital,being injected continuously on the rate of 2550 μg/(min·kg) in the following 24 hours,besides using urokinase,heparin,isosorbide dinitrate,ACEI,simvastatin，and started to use metoprolol by mouth 30 min before stopping use esmolol.The control groups began to use Betaloc on the 3th days of hospitalization,observing 30 days,and on the 21 th day evaluate the changes in configuration and function of heart by echocardiography.Results All patients could tolerate esmolol very well .There were no distinction in postinfarction angina pectoris,arrhythmia and death during the period of observation,the heart failure of study groups was lower obviously than that of the control groups(0.01).By echocardiography, we found there was no obvious distinction also in configuration and function of heart between two groups,LVEF of study groups was higher 5% than that of control groups(P gt0.05).Conclusion The therapy of esmolol was effective，safe and tolerative in the patients with myocardial infarction and acute left heart failure. 　　【Key words】 acute myocardial infarction, acute left heart failure, esmolol,metoprolol 　　β阻断剂治疗急性心肌梗死的疗效已得到充分肯定，在