右美托咪定与倍他乐克抗交感活性对比研究

Comparative study on anti-sympathetic activity ofdexmedetomidine with metoprolol

目的比较右美托咪定与倍他乐克的抗交感活性作用。方法将137例急性左心衰竭患者分为C、M、D 3组,均给予无创呼吸机辅助呼吸、扩血管、利尿、镇静等常规治疗,在此基础上,M组予倍他乐克治疗,D组予右美托咪定治疗。行脉搏指示连续心排血量(PiCCO)监测心排血量(CO)、心指数(CI)、血管外肺水(EVLWI)等,检测血浆脑型利钠肽(BNP)评估心功能状态,测定血浆去甲肾上腺素(NE)、肾上腺素(E)评估交感活性。结果治疗后,M组和D组CO、CI、EVLWI、BNP、血浆NE及E水平与C组比较均有显著性差异(P均<0.05),M组与D组比较无显著性差异(P>0.05)。结论右美托咪定与倍他乐克具有等同抗交感活性作用,可有效改善心功能,适用于心力衰竭患者。

Objective It is to compare the effect of anti-sympathetic activity dexmedetomidine and metoprolol. Methods 137 patients with acute heart failure were randomly divided into 3 groups. All patients were treated by routine therapeutics such as noninvasive ventilator assistant respiration, vasodilators, diuresis, sedation et al. On the basis of routine therapeutics, the patients were treated with metoprolol in Group M, and with dexmedetomidine in Group D. The indicators of cardiac output （CO）, cardiac index （CI） and extravascular lung water （EVLWI） were monitored by pulse indicate continuous cardiac out- put （PiCCO）, plasma brain natriuretic peptide （BNP） was detected for the assessment of cardiac functional status, and plas- ma norepinephrine （NE）, epinephrine （E） were measured to assess sympathetic activity. ResultsAfter treatment, there were significant differences in the levels of CO, CI, EVLWI, BNP, plasma NE and E in Group M and D that compared with Group C （ all P 〈 0.05 ） , but was no significant difference between group M and Group D （ P 〉 0.05 ）. Conclusion Anti-sympathetic activity of dexmedetomidine is equivalent to metoprolol, it can effectively improve heart function and to be used in patients with heart failure.