超短效β阻滞剂治疗严重冠脉病变患者心肌缺血疗效的观察(英文)

Efficacy of ultra-short-acting β-blocker on cardiac ischemia in patients with serious coronary lesions

目的：探讨超短效β受体阻滞剂艾司洛尔缓解严重冠状动脉病变所致心肌缺血的效果。方法：连续入选冠状动脉病变严重的冠心病患者57例,男34例,女23例,年龄55~87,平均（69±19）岁。所有入选患者均具有与心肌缺血相关的典型症状,心电图有缺血性ST-T改变,不具备条件或不愿意行血运重建,常规使用硝酸酯、吗啡等药物后症状未能完全缓解;给予盐酸艾司洛尔注射液,以用药前及之后4h为疗效评价时间点;其指标包括症状评分、血常规及心肌标记物,心电图和超声心动图等指标。结果：41例显效,9例有效,7例无效,有效率达87.7%。41例显效患者在用药后（66±23）min症状完全缓解（P〈0.0001）,心率和血压均显著下降（P〈0.0001）,心电图ST段恢复至基线（P〈0.0001）。9例有效患者在用药后4h症状获得部分缓解,与缺血相关症状减轻（59.1±13.9）%（P〈0.0001）,心率和血压均显著下降（P〈0.0001）,心电图ST段较用药前恢复60.1%（P〈0.0001）。所有患者用药期间均无严重不良反应。结论：艾司洛尔可迅速、安全、有效缓解因严重冠脉病变导致的心肌缺血症状和心电图ST-T变化。

Objective：To explore the efficacy of Esmolol on cardiac ischemia in patients with serious coronary lesions who are not candidates for coronary revascularizations.Methods：Fifty seven aged patients（34 male） with serious coronary artery disease not candidates for coronary revascularizations were included.All patients had classical angina involved in cardiac ischemia,and definitely ischemic ST-segment depressions in surface electrocardiogram,however which were not relieved by routine treatment including intravenous nitrate or even morphine.All patients received loading dose injection and continuously intravenous infusion of Esmolol,and the baseline characteristics before treatment and the effects at 4 hours after infusion of Esmolol were carefully recorded.Results：After infusion of Esmolol,the ischemia-related symptoms of 41 patients completely relieved,and their ST depressions recovered to the baseline accompanied with significant reduction in blood pressure and heart rate（P0.0001 all） within（66±23） min.Moreover,nine patients were observed that their ischemia-related symptoms relieved and ST alteration recovered partially（P0.0001 both） at 4 h after continuous infusion of Esmolol.Conclusion：Esmolol is effective to relieve the serious cardiac ischemia-related symptoms and ST-T alteration of ECG in patients with serious coronary lesions.