静脉使用美托洛尔治疗急性前壁心肌梗死的近期疗效  

The short-term clinical efficacy of intravenous metopmlol on patients with acute anterior myocardial infarction

作　　者：张丽媛[1] 贾志[1] 郭牧[1] 张云强[1] 王群[1] 宋昱[1] 

机构地区：[1]天津医科大学心血管病临床学院/泰达国际心血管病医院,300457

出　　处：《中国医疗前沿》2012年第22期18-20,共3页China Healthcare Innovation

摘　　要：目的观察静脉使用美托洛尔治疗急性前壁心肌梗死患者的近期临床疗效和安全性。方法入选362例急性前壁心肌梗死患者,随机分为静脉组(179例)和口服组(183例),静脉组静脉注射酒石酸美托洛尔,继之口服;口服组直接给予口服制剂。比较两组患者住院7d及3个月心脏不良事件和1个月心脏超声资料。结果与口服组比较,静脉组住院7d严重心律失常(14.0%Vs 25.7%,P<0.01)及主要心脏不良事件(MACE)(10.1%Vs 18.0%,P<0.05)减少。1个月随访,两组左室射血分数均逐渐增加,且7d及1个月静脉组均优于口服组[(55.70±5.92)%Vs(53.18±8.06)%,P<0.01,(58.74±6.32)%Vs(56.38±8.24)%,P<0.01]。结论早期静脉应用美托洛尔可更有效改善血流动力学稳定的急性前壁心肌梗死患者的近期预后,且不增加早期心衰的风险。Objective To observe the short-term clinical efficacy and safety of intravenous metoprolol on patients with acute anterior myocardial infarction.Methods 362 patients suffered from acute anterior myocardial infarction were randomly divided into two groups： intravenous group（n=179） and oral group（n=183）.All patients were given conventional treatment,patients in intravenous group were injected metoprolol intravenously at doses of 5-15mg and then treated with oral metoprolol,patients in oral group were treated with oral metoprolol.The clinical effectiveness including the incidence of adverse cardiac events during 7 days and 3 months follow-up and cardiac ultrasound data at one month were compared between the two groups.Results Compared with oral group,the malignant arrhythmia（14.0% Vs.25.7%,P 0.01） and major adverse cardiac events（MACE）（10.1% Vs 18.0%,P 0.05） in intravenous group were decreased markedly.During 1 month follow-up period,left ventricular ejection fraction（LVEF）in both group all increase gradually,and the LVEF improvement in intravenous group was more remarkable at 7 days and three months [（55.70±5.92）% Vs（53.18±8.06）%,P 0.01,（58.74±6.32）% Vs（56.38± 8.24]%,P 0.01].Conclusion The injection of metoprolol can effectively improve the short-term clinical effect without increasing heart failure in haemodynamically stable patients with acute anterior myocardial infarction.

关 键 词：急性心肌梗死 美托洛尔 预后 静脉 

分 类 号：R542.2[医药卫生—心血管疾病]