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目的观察静脉注射美托洛尔治疗急性心肌梗死(AMI)早期的临床疗效。方法88例AMI患者随机分为对照组44例、治疗组44例;对照组常规给予rt-pA、低分子肝素钙、阿司匹林、ACEI、硝酸甘油等药物,治疗组在常规治疗的基础上,静脉注射美托洛尔5mg(1mg/min),共3次,每次间隔5min,静脉注射完成后,根据病情口服美托洛尔25～50mg,每12h一次。结果静脉应用美托洛尔后,患者心率明显下降,由(108±14)次/min降至(87±12)次/min(P<0.05);早期静脉应用美托洛尔可以有效预防、治疗心律失常,与对照组相比,差异有统计学意义(P<0.05);在缓解心绞痛、保护心功能、心肌酶峰值及峰值出现时间、住院后再梗死、梗死后心绞痛、死亡等心脏终点事件明显优于对照组(P<0.05);低血压、心动过缓等发生率相比较差异无统计学意义(P>0.05)。结论在急性心肌梗死早期静脉应用美托洛尔安全、有效,疗效显著,可明显改善预后。
Objective To observe the clinical efficacy of intravenous metoprolol in the early stage of acute myocardial infarction (AMI). Methods A total of 88 AMI patients were randomly divided into control group (n = 44) and treatment group (n = 44). The control group was given rt-pA, low molecular weight heparin, aspirin, ACEI and nitroglycerin on a routine basis. Metoprolol injection 5mg (1mg / min), a total of 3 times, each interval 5min, intravenous injection is completed, according to the condition of oral metoprolol 25 ~ 50mg, once every 12h. Results After intravenous metoprolol, heart rate decreased significantly from (108 ± 14) times / min to (87 ± 12) times / min (P <0.05); early intravenous metoprolol can effectively prevent and treat Compared with the control group, the difference was statistically significant (P <0.05). In the process of ameliorating angina pectoris, protecting cardiac function, peak and peak time of myocardial enzymes, cardiac end point events such as recurrent infarction, post-infarction angina pectoris and death in hospital (P <0.05). There was no significant difference in the incidence of hypotension and bradycardia between the two groups (P> 0.05). Conclusion Intravenous metoprolol in the early stage of acute myocardial infarction is safe, effective and effective. It can significantly improve the prognosis.