美托洛尔对室上性心动过速并心肌缺血病人全麻时的保护

The Protection of Metoprolol to Patients with Supraventricular Tachycar-dia and Myocardial Ischemia Received General Anesthesia

目的探讨预注美托洛尔对室上性心动过速并心肌缺血病人全麻时的应用效应。方法50例病人随机分为对照组(A组)和美托洛尔组(B组),每组25例。B组患者给予美托洛尔0.1mg/kg,稀释后以0.02mg(/kg·min)静脉泵推注,A组则以等量的生理盐水同法注入。注毕5min后麻醉诱导插管。记录麻醉前基础值(T0)、用药后(T1)、气管插管后(T2)、麻醉平衡后(T3)、用药后90min(T4)的血流动力学指标和心电图变化。结果A组T1时MAP、HR、RPP值与T0比较差异均无统计学意义(P>0.05);B组T1时MAP值与T0比较差异亦无统计学意义(P>0.05),但T1、T2、T3、T4时HR、RPP值与T0比较均有统计学意义(P<0.01)。两组各时点MAP值比较差异无统计学意义(P>0.05);但B组T1、T2、T3、T4时HR及RPP值均明显低于A组(P<0.01)。A组各时点S-T段下移幅度比较差异无统计学意义(P>0.05),B组T1、T2、T3、T4时S-T段下移幅度减小,与T0比较差异有统计学意义(P<0.05);且B组T1、T2、T3、T4时S-T段下移幅度明显低于A组(P<0.05或P<0.01)。结论美托洛尔用于室上性心动过速并心肌缺血病人能有效地降低心肌氧耗、改善心肌氧供,具有保护作用。

Objective To observe the effects of pre-medication with metoprolol on patients with supraventricular tachycardia and myocardial ischemia undergoing general anesthesia. Methods Fifty patients were divided into two groups randomly：the control group （group A）,the metoprolol group（group B）. Each group include 25cases. Group B received mainline of metoprolol 0.1mg/kg at a rate of 5mg/ （kg ·h,） and group A received normal saline as the control. Various circulation function monitoring indexes, changing of electrocardiogram were recorded before administration （To）, after medication （Tl）,after intubation （T2）,after equation of anesthesia（T3）, 90min after administration（T a）. Results In group A, MAP, HR and RPP was no marked differences at T1 with T0（P 〉 0.05）. But in group B, MAP was not changed significantly at T1 with T0（P〉0.05）;HR, RPP was significant differences at T1,T2,T3 and T4 with T0（P〈0.01）. comparing the two groups, MAP was no marked differences at each time （P〉 0.05）. But in group B, HR and RPP was significantly decreased at T1, T2, T3 and T4 than at To （P〈 0.01 ）. In group A, the downward shift distance of S-T section was not changed significantly at each time （P 〉 0.05 ）. But in group B, that was significantly decreased at T1, T2, T3 and T4 than that of T0（P 〈 0.05 ）, and was significantly decreased than that in group A（P〈0.05 or P〈0.01）. Conclusion Metoprolol is effective in lessening myocardial oxygen consumption, and improving myocardial blood oxygen supply on patients with supraventricular tachycardia and myocardial ischemia.has protective effects.