摘要
目的比较冠心病(CHD)患者冠状动脉不同病变程度与发生心肌缺血的关系,探讨超短效β阻滞剂艾司洛尔缓解冠心病心肌缺血的效果。方法利用冠状动脉造影确定(CHD患者)冠脉病变支数和狭窄程度;应用动态心电图(DCG)记录,分析不同程度冠脉病变CHD患者心肌缺血的发作阵次、持续时间、ST段下移幅度和发作时心率;对心肌缺血患者常规使用硝酸酯、吗啡等药物后未能完全缓解者,给予盐酸艾司洛尔注射液,以用药前和用药后4h作为评价时间点,评价指标主要包括症状评分、心电图ST段压低、心率和血压。结果 163例中有126例出现缺血性ST段改变,在不同程度冠脉病变支数和狭窄程度间比较差异有统计学意义(P<0.05或P<0.01);采用艾司洛尔治疗的103例患者中有86例有效,治疗有效率为83.5%,其中,59例显效患者用药(68±21)min后症状完全缓解(P<0.01),心率和血压均显著下降(P<0.01),心电图ST段基本恢复至基线(P<0.01)。结论冠脉病变支数、狭窄程度与心肌缺血的发生率有关;艾司洛尔可迅速、安全、有效缓解冠脉病变所致心肌缺血。
Objective To investigate the relationship between different degrees of coronary and myocardial ischemia in patients with coronary heart disease（CHD）,and the effect of esmolol in the treatment of myocardial ischemia caused by coronary artery disease.Methods Coronary lesion counts and stenosis degree were determined using coronary angiography.Array onset times,duration,ST segment depression and heart rate of myocardial ischemia in CHD patients induced by different coronary artery disease degrees were analyzed using dynamic electrocardiogram（DCG） records.Patients with myocardial ischemia with no improvements by routine treatment of intravenous nitrate or even morphine,were then given esmolol hydrochloride injection.Symptom score,ST-segment depression,heart rate and blood pressure were evaluated before treatment and four hours after treatment.Results Of the 163 patients,126 had ischemic ST segment change,and patients showed statistically significant difference in coronary lesion counts and stenosis degree（P0.05 or P0.01）;Among the 103 patients treated by esmolol,86 were found with improved clinical symptoms,with the effective rate of 83.5%.59 of the 86 cases were found markedly effective,in which the symptoms were completely remitted after（68±21） min,the heart rate and blood pressure were significantly decreased,P0.01,and ST segment recovered to baseline P0.01.Conclusion Coronary artery disease counts and stenosis are related to the incidence of myocardial ischemia.Esmolol can relieve myocardial ischemia induced by coronary artery disease quickly,safely and effectively.
出处
《海南医学》
CAS
2012年第10期9-11,共3页
Hainan Medical Journal
关键词
艾司洛尔
冠心病
心肌缺血
Esmolol
Coronary heart disease
Myocardial ischemia
