急性左心衰患者使用右美托咪定与酒石酸美托洛尔的抗交感活性对比研究  

Comparative study of anti-sympathetic activity of dexmedetomidine and metoprolol in acute left heart failure patients

作　　者：方志成[1] 郑翔[1] 刘伯毅[1] 陈黎[1] 盛春风[1] 

机构地区：[1]湖北医药学院附属太和医院重症医学科,湖北省十堰市442000

出　　处：《临床麻醉学杂志》2013年第11期1079-1081,共3页Journal of Clinical Anesthesiology

摘　　要：目的评价右美托咪定与酒石酸美托洛尔治疗急性左心衰患者抗交感活性作用效果。方法 137例急性左心衰患者分为对照组(C组,44例)、酒石酸美托洛尔组(M组,47例)、右美托咪定组(D组,46例),治疗前(T0)、治疗后第1天(T1)、第2天(T2)、第3天(T3)、第4天(T4)、第5天(T5)行脉搏指示连续心排血量监测(PiCCO)监测心排血量(CO)、心脏指数(CI)、血管外肺水(EVLWI)等,检测血浆脑型利钠肽(BNP)评估心功能状态,T0、T1、T3、T5时测定血浆去甲肾上腺素(NE)、肾上腺素(E)评估交感活性。结果 T3时M、D组CI、CO明显高于,EVLWI明显低于C组(P<0.05);T3时M、D组血浆BNP水平均明显低于T0时(P<0.05);T3、T5时M、D组血浆NE、E浓度明显低于T0时(P<0.05)。结论右美托咪定与酒石酸美托洛尔具有等同抗交感活性作用,可用于心衰患者。Objective To evaluate the effects of anti-sympathetic activity of dexmedetomidine and metoprolol in acute left heart failure patients. Methods One hurdred thirty-seven patients of acute heart failure were randomly divided into control group （group C, n = 44）, metoprolol group （group M, n=46） and dexraedetomidine group （group D, n=47）. Hemodynamic indicators of cardiac output （cardiac output, CO）, cardiac index （cardiac index, CI）,extravascular lung water （extravascular lung water, EVLWI） was monitored with PiCCO, and plasma brain natriuretic peptide （natriuretic peptide, BNP） was assessed for cardiac functional status pre-treatment （T0） and on 1 d（T1 ）, 2 d（T2）, 3 d （T3）, 4 d（T4 ）, 5 d（T5 ） post-treatment. Plasma concentration of norepinephrine （NE）, epinephrine （E） was evaluated pre-treatment and on days 1, 3, 5 post-treatment for the sympathetic activity. Results Compared with group C,CI,CO in groups M and D were significantly higher, while EVLWI were significantly lower at T3 （P〈0. 05） ; BNP in all three groups at T3 were significantly lower than those at To （P〈0.05）, the plasma NE, E at T3 ,T5 at T3 decreased obviously compared with that in three groups at To （P〈 0. 05）. Conclusion Anti-sympathetic active of dexmedetomidine was equivalent to metoprolol in patients with heart failure.

关 键 词：右美托咪定 酒石酸美托洛尔 心力衰竭 

分 类 号：R541.6[医药卫生—心血管疾病]