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目的研究冠状动脉内注射美托洛尔对介入性心肌损伤的保护作用。方法将86例行冠状动脉介入治疗(PCI)的患者随机分为试验组和对照组。两组在PCI前向冠状动脉内分别注射美托洛尔2mg(1mg/ml)和同等容积的生理盐水安慰剂。测定术前1h、术后6h、术后24h的血清肌钙蛋白I(cTNI)、肌酸激酶同工酶MB(CKMB)的变化,记录患者的胸痛症状以及心率、血压变化和球囊(或支架)的扩张压力、扩张次数。结果对照组与试验组之间cTNI、CKMB比较差异有统计学意义(P=0.004,0.003);两组的心率、血压和扩张压力、扩张次数比较差异均无统计学意义(P>0.05)。冠状动脉内注射2mg美托洛尔未见明显的不良反应。结论冠状动脉内注射小剂量美托洛尔是安全有效的。在介入治疗时能在一定程度上有效地保护心肌细胞,减少心肌细胞的损伤;其对心率、血压影响不明显。
Objective To investigate the protective effect of intra-arterial injection of metoprolol on myocardial injury induced by intervention. Methods Totally 86 patients undergoing coronary artery interventional therapy (PCI) were randomly divided into experimental group and control group. Two groups were given intraperitoneal injection of metoprolol 2mg (1mg / ml) and the same volume of saline placebo before PCI. The changes of serum cTNI and CKMB were measured at 1 hour before operation, 6 hours after operation and 24h after operation. The changes of chest pain, heart rate, blood pressure, Stent) expansion pressure, the number of expansion. Results There were significant differences in cTNI and CKMB between the control group and the experimental group (P = 0.004, 0.003). There was no significant difference in heart rate, blood pressure, dilatation pressure and the number of dilation between the two groups (P> 0.05). No significant adverse reactions were observed with intracoronary injection of 2 mg of metoprolol. Conclusion Intracoronary injection of low dose metoprolol is safe and effective. In interventional therapy can protect the myocardial cells to a certain extent, reduce the damage of cardiomyocytes; its impact on heart rate and blood pressure is not obvious.