美托洛尔对溶栓治疗老年急性心肌梗死预后的影响

The Effects of Metoprolol on Prognosis of Aged Patients with Acute Myocardial Infarction after Thrombolytic Therapy

临床观察 β 受体阻滞剂美托洛尔对溶栓治疗老年急性心肌梗死 (AMI)预后的影响。将 2 0 0例AMI老年病人随机分为美托洛尔组 (110例 )和对照组 (90例 ) ,并对 177例出院存活者进行了为期 2 4个月的随访。结果显示 ,住院期间 ,美托洛尔组的再梗死、心力衰竭 (KillipⅢ /Ⅳ级 )、心绞痛、恶性心律失常和猝死发生率分别为 3.7%、6 .6 %、12 %、7.5 %和 3 .7% ,均低于对照组的 8%、15 %、2 4%、17%和 8% (P <0 .0 5 ) ;随访期间 ,美托洛尔组的再梗死、心力衰竭 (KillipⅢ /Ⅳ级 )、心绞痛和心性猝死发生率分别为 4%、7%、15 %和 4% ,均低于对照组的 10 %、18%、2 9%和 10 % (P <0 .0 5 ) ;美托洛尔组的LVEDD、LVESD、LVEF和CI等远期心功能指标显著优于对照组。提示 ,美托洛尔可加强溶栓疗效 ,降低老年AMI病人的死亡率和心脏意外事件发生率 。

To explore the effcts of metoprolol on prognosis of aged patients with acute myocardial infarction (AMI)after throbllytic therapy ,200 aged patients with AMI were at random divided into metoprolol group( n =110) and control group( n =90), and 117 homed patients were followed up every month for two years. The results showed the incidences of reinfarcition ,heart failure,angina,malignant arrhythmia and sudden death in metoprolol group (3.7%,6.6%,12% and 3.7%,respectivelly)were lower than those in control group, no matter what in short term or in long term ( P <0.05). LCEDD ,LVESD,LVEF and CI in metoprolol group were improved more greatly than those in control group ( P <0.05).It was suggested that the efficacy of thrombolytic therapy was increased and adverse events of heart were reduced in metoprolol group and long term treatment using metoprolol might contibute to improvement of prognosis of aged patients with AMI.