静脉注射艾司洛尔对肥厚型心肌病心脏功能的影响  

The effects of esmolol by vein injection on cardiac function in patients with hypertrophic cardiomyopathy

作　　者：白晨[1] 钟明[1] 黎莉[1] 赵静[1] 巩会平[1] 张运[1] 张薇[1] 

机构地区：[1]山东大学齐鲁医院心内科,山东济南250012

出　　处：《中国老年学杂志》2006年第12期1603-1604,共2页Chinese Journal of Gerontology

基　　金：国家自然科学基金(39970294)

摘　　要：目的探讨β受体阻滞剂艾司洛尔对肥厚型心肌病患者血流动力学及左室收缩和舒张功能的影响。方法采用超声心动图-心导管同步血流动力学技术,测定13例肥厚型心肌病(HCM)患者(9例非梗阻性,4例梗阻性)静脉注射艾司洛尔前后的左室收缩和舒张功能。结果静脉注射艾司洛尔后HCM患者心率、收缩压、左室收缩压和左室射血分数明显减低(P<0.05,P<0.001),舒张压、左室压力最大上升速率无明显变化;左室流出道压差有减低趋势,其中4例梗阻性HCM患者用药后左室流出道压差明显减低〔(57.00±9.2)mmHg vs(23.27±12.96)mmHg,P<0.05〕;左室松弛时间常数、心腔僵硬度常数和左室压力最大下降速率无明显变化;左室舒张末压明显减低〔(19.62±10.55)mmHg vs(11.18±7.5)mmHg,P<0.05〕。结论艾司洛尔通过减低心肌收缩力、降低心脏后负荷和减慢心率而改善心肌顺应性,特别适用于梗阻性HCM患者。Objective To study the effects of esmolol on hemodynamic and left ventricular systolic and diastolic function in patients with hypertrophic cardiomyopathy （HCM）. Methods The echocardiography and left ventricular catheterization were performed simultaneously in 13 patients with HCM （9 cases without obstruction, 4 cases with obstruction） to observe the left ventricular systolic and diastolic function before and after esmolol injection. Results Left ventricular ejection fraction, heart rate, systolic blood pressure, and left ventricular systolic pressure were reduced significantly after intravenous esmolol （ P 〈 0. 05 - 0. 001 ）. There was obvious change in diastolic pressure and maximum upstroke velocity of left ventricular pressure. In 4 patients with obstructive HCM, esmolol decreased left ventricular outflow tract gradient significantly [ （57.00 ± 9.2） vs （23.27 ± 12.96） mmHg, P 〈 0.05 ]. Left ventricular relaxation time constant, dp/dtmax and chamber stiffness were not altered. Left ventricular end diastolic pressure obviously decreased [ （ 19.62 ± 10.55） vs （ 11.18 ± 7.58） mmHg, P 〈 0.05 ]. Conclusions Esmolol could improve left ventricular compliance through reducing left ventricular contractility, loading condition and heart rate, especially in obstructive HCM patients.

关 键 词：Β受体阻滞剂 肥厚型心肌病 

分 类 号：R542.2[医药卫生—心血管疾病]