卡维地洛对心肌梗死患者血清儿茶酚胺水平的影响

Effect of carvedilol on the stability of plasma catecholamine in patients with myocardial infarction

目的探讨卡维地洛对心肌梗死后患者血儿茶酚胺水平的影响。方法急性心肌梗死患者36例，随机分为实验组与对照组，实验组予卡维地洛治疗12个月，对照组则予以常规美托洛尔治疗12个月，比较两组血浆去甲肾上腺素和肾上腺素含量的变化并随访新的心脏事件发生情况。结果在随访、监测12个月期间，实验组血浆去甲肾上腺素和肾上腺素浓度均明显低于对照组（P〈0．05），实验组急性心力衰竭、再梗死、恶性心律失常及猝死的发生率亦显著低于对照组（P〈0．05）。结论卡维地洛可使交感神经活性处于平稳状态，从而降低新的心脏事件发生率。

Objective To study the effects of carvedilol on the stability of plasma cateeholamine in patients with post-acute myocardial infarction during consecutive periods. Methods Thirty-six patients selected with acute myocardial infarction were randomized to experimental group treated with the nonselective beta-blocker carvedilol（ n = 18） and control group treated with the selective beta-blocker metoprolol（ = 18 ） for 12-months follow-up. In the two groups ,the concentrations of plasma norepinephrine and epinephrine were measured before the treatment and after 2 months,4 months ,6 months ,8 months, 10 months and 12 months and new cardiac events were supervised. Results After the treatment, in each point of periods, experimental group showed lower concentrations of plasma norepinephrine and epinephrine statistically than control group（ P 〈 0.05 ）, and a stable dynamic change during 12 months of treatment（ P 〉 0.05 ） ;the occtrrrence rate of new cardiac events was lower significantly in experimental group than in control group（P 〈 0.05）. Conclusion Carvedilol can decrease the spillover of sympathetic nerve, control more stably eardiac sympathetic nerve activity and then decrease more sharply the occurrence rate of new cardiac events in patients with acute myocardial infarction than metoprolol.