早期静注倍他乐克治疗急性心肌梗死140例临床观察  

Clinical observation of early intravenous injection with metoprolol in 140 patients with acute myocardial infarction

作　　者：齐新颜[1] 李金龙[1] 张小丽[1] 王磊[2] 

机构地区：[1]泰安市中心医院心内科,山东泰安271000 [2]泰安市中心医院肿瘤外科,山东泰安271000

出　　处：《泰山医学院学报》2006年第2期117-119,共3页Journal of Taishan Medical College

摘　　要：目的观察早期静注倍他乐克治疗急性心肌梗死（AMI）的临床疗效。方法对已确诊的140例急性心肌梗死患者，按照倍他乐克的使用情况，随机分为试验组和对照组。两组入选后均常规给予尿激酶（uk）150万u静脉溶栓，低分子肝素（LMWH）、阿司匹林、硝酸甘油等综合治疗，其中两组均有30例行经皮冠状动脉介入干预（PCI）治疗。试验组入院后尽快给予静脉注射倍他乐克5mg（1mg／min），共3次，每次间隔5min，观察血压、心率的变化，总量15mg。静脉注射完成15min后，开始口服普通倍他乐克每6h 1次，每坎12．5～25mg，连续1个月、对照组入院后给予口服倍他乐克12．5～25mg每8h 1次，逐渐加量最大50mg／次。对两组疗效进行对照分析。结果试验组较对照组室性心律失常、室颤、心衰、再梗死率、ST段抬高持续天数、病死率的发生均显著下降（P〈0．01）。低血压、房室传导阻滞（A-VB）等并发症的发生率差异无显著性（P〉0．05）。结论早期静注倍他乐克可改善急性心肌梗死的预后。Objective： To demonstrate the effect of early intravenous injection （i. v. ）with metoprolol on patients with acute myocardial infarction {AMI）. Methods 140 patients after AMI were randomly divided into the expcriment and control groups according to the treatment with metoprolol. The two groups were all treated with combined ther apy of urokinase, LMWA, aspirin and Nitroglycerin. There were 30 patients treated with PCI in each of the two groups. The experiment group received 5mg metoprolol i. v. as soon as possible after being hospitalized, all together three times in every 5 minutes with the total of 15mg. During the period, the change of blood pressure and hearl rate were carefully observed. Then the case group began oral application of metoprolol 12.5-25 mg q6h for one month after finishing with i. v. 15 mg metoprolot. The control group were treated with oral application of metoprolol 12.5 -25 mg q8h and gradually added to 50 mg every time. The effect of the two groups were analyzed with T-test after one month. Results There were significant decrease in the rate of venericular arrhythmia, vf, congestive heart failure, reinfarction,the persistent time of ST-segment elevating and fatality rate in the case group. There were no significant change in the rate of hypotension and A-V block in the two groups（T-test, P 〉 0.05）. Conclusion Early treatment with metoprolol i.v. can improve the prognosis of patients with AMI.

关 键 词：急性心肌梗死 倍他乐克 静脉注射 

分 类 号：R542.22[医药卫生—心血管疾病]