静脉注射艾司洛尔治疗急性心肌梗死合并交感风暴的临床观察  

Clinical observation of intravenous esmolol in the treatment of acute myocardial infarction patients with sympathetic storm

作　　者：董小燕[1] 于东明[1] 郭伟[1] 袁靖[1] 

机构地区：[1]首都医科大学附属北京天坛医院急诊科,北京100050

出　　处：《中国急救复苏与灾害医学杂志》2015年第12期1159-1161,共3页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：2014年度首都医科大学基础临床合作研究基金：耐碳青霉烯类肺炎克雷伯菌对消毒机抗性极其耐药机制研究（14JL29）

摘　　要：目的观察静脉注射艾司洛尔治疗急性心肌梗死合并交感风暴的临床疗效。方法急性心肌梗死合并交感风暴患者44例，随机分为3组。其中胺碘酮组（n=15），应用常规心肺复苏及电复律加静脉应用胺碘酮治疗；酒石酸美托洛尔组（n=15），在胺碘酮组治疗基础上静脉联合酒石酸美托洛尔治疗；艾司洛尔组（n=14），在胺碘酮组治疗基础上联合静脉应用艾司洛尔治疗。结果艾司洛尔组及酒石酸美托洛尔组终止反复室性心动过速、心室颤动成功率明显高于胺碘酮组；艾司洛尔组及酒石酸美托洛尔组终止室速、心室颤动所需电复律次数显著少于胺碘酮组；低血压发生率及心动过缓发生率3组间差异无统计学意义。结论急性心肌梗死患者合并交感风暴时，在常规治疗的基础上，及时静脉注射艾司洛尔治疗是有效及安全的，能显著提高抢救成功率。Objective To observe the clinical efficacy of intravenous injection of esmolol to treat acute myocardial infarction patients with sympathetic storm. Methods A total of 44 acute myocardial infarction patients with sympathetic storms were randomly divided into three groups： an amiodarone group receiving intravenous amiodarone in addition to conventional cardiopulmonary resuscitation and electrical cardioversion （n=lS）, a metoprolol tartrate group which was treated with intravenous metoprolol tartrate in addition to the above amiodarone therapy （n=lS）, and an esmolol group which was intravenously injected with esmolol in addition to the above amiodarone therapy （n=14）. Results The esmolol group and metoprolol tartrate group produced markedly higher inhibitory rates of recurrent ventricular tachycardia and ventricular fibrillation than the amiodarone group. The esmolol group and metoprolol tartate groups required substantially less times of electric cardioversion to terminate ventricular tachycardia and ventricular fibrillation than the amiodarone group. There was no statistical difference as to the incidences of hypotension and bradycardia among these three groups. Conclusion Based on the conventional therapy, intravenous injection of esmolol can significantly improve the successful rate of rescue for acute myocardial infarction patients with sympathetic storm.

关 键 词：急性心肌梗死 室性心动过速 心室颤动 艾司洛尔 交感风暴 

分 类 号：R540.4[医药卫生—心血管疾病]